View Information Collection (IC)
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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
SNAP-Eligible Qualitative Research (Individuals/Households 18-75 years) Respondents + non-respondents
Agency IC Tracking Number:
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-Attachment C-1 Screener (English)_062718.docx
Attachment C-1 Screener (English)_062718.docx
No
Paper Only
Other-Attachment C-2 Screener (Spanish)_062718.docx
Attachment C-2 Screener (Spanish)_062718.docx
No
Paper Only
Other-Attachment E-1 Focus Group Confirmation Form (English)_062718.docx
Attachment E-1 Focus Group Confirmation Form (English)_062718.docx
No
Paper Only
Other-Attachment E-2 Focus Group Confirmation Form (Spanish)_062718.docx
Attachment E-2 Focus Group Confirmation Form (Spanish)_062718.docx
No
Paper Only
Other-Attachment F-1 Focus Group Guide (English)_062718.docx
Attachment F-1 Focus Group Guide (English)_062718.docx
No
Paper Only
Other-Attachment F-2 Focus Group Guide (Spanish)_062718.docx
Attachment F-2 Focus Group Guide (Spanish)_062718.docx
No
Paper Only
Other-Attachment G-1 Focus Group Stimuli Email Newsletter (English)(1).pdf
Attachment G-1 Focus Group Stimuli Email Newsletter (English) (1).pdf
No
Paper Only
Other-Attachment G-2 Focus Group Stimuli Email Newsletter (Spanish)(1).pdf
Attachment G-2 Focus Group Stimuli Email Newsletter (Spanish) (1).pdf
No
Paper Only
Other-Attachment H-1 Focus Group Stimuli Social Media (English)(1).pdf
Attachment H-1 Focus Group Stimuli Social Media (English) (1).pdf
No
Paper Only
Other-Attachment H-2 Focus Group Stimuli Social Media (Spanish) (1).pdf
Attachment H-2 Focus Group Stimuli Social Media (Spanish) (1).pdf
No
Paper Only
Other-Attachment I-1 Focus Group Stimuli Apple and Peanut Butter Wrap Video (English).docx
Attachment I-1 Focus Group Stimuli Apple and Peanut Butter Wrap Video (English).docx
VIDEO TRANSCRIBED
No
Paper Only
Other-Attachment I-2 Focus Group Stimuli Apple and Peanut Butter Wrap Video (Spanish).docx
Attachment I-2 Focus Group Stimuli Apple and Peanut Butter Wrap Video (Spanish).docx
VIDEO TRANSCRIBED
No
Paper Only
Other-Attachment J-1 Focus Group Stimuli Frozen Fruit Cups Video (English).docx
Attachment J-1 Focus Group Stimuli Frozen Fruit Cups Video (English).docx
VIDEO TRANSCRIBED
No
Paper Only
Other-Attachment J-2 Focus Group Stimuli Frozen Fruit Cups Video 8-1-18 (Spanish).docx
Attachment J-2 Focus Group Stimuli Frozen Fruit Cups Video 8-1-18 (Spanish).docx
VIDEO TRANSCRIBED
No
Paper Only
Other-Attachment K-1 Focus Group Handout #1 (English)_062718.docx
Attachment K-1 Focus Group Handout #1 (English)_062718.docx
No
Paper Only
Other-Attachment K-2 Focus Group Handout #1 (Spanish)_062718.docx
Attachment K-2 Focus Group Handout #1 (Spanish)_062718.docx
No
Paper Only
Other-Attachment L-1 Focus Group Handout #2 (English)_062718.docx
Attachment L-1 Focus Group Handout #2 (English)_062718.docx
No
Paper Only
Other-Attachment L-2 Focus Group Handout #2 (Spanish).docx
Attachment L-2 Focus Group Handout #2 (Spanish).docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
Food and Nutrition Assistance
Privacy Act System of Records
Title:
FNS-8 USDA/FNS Studies and Reports
FR Citation:
65 FR 17251
Number of Respondents:
840
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
840
0
840
0
0
0
Annual IC Time Burden (Hours)
497
0
497
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Generic OMB Memo Aug 21 2018
0584-0523 Generic Clearance Memo 8.21.18.docx
08/27/2018
Attachment A-1 Privacy Act Statement (English)_062718.docx
Attachment A-1 Privacy Act Statement (English)_062718.docx
08/01/2018
Attachment A-2 Privacy Act Statement (Spanish)_062718.docx
Attachment A-2 Privacy Act Statement (Spanish)_062718.docx
08/01/2018
Attachment B-1 Confidentiality Agreement_062718.docx
Attachment B-1 Confidentiality Agreement_062718.docx
08/01/2018
Attachment D-1 Consent Form (English)
Attachment D-1 Consent Form (English)_062718.docx
08/01/2018
Attachment D-2 Consent Form (Spanish)_062718.docx
Attachment D-2 Consent Form (Spanish)_062718.docx
08/01/2018
Attachment M-1 Burden Hours Table_062718.xlsx
Copy of Attachment M-1 Burden Hours Table_062718 (002).xlsx
08/27/2018
Attachment N Social Marketing and PSE Descriptions from SNAP Plan Guidance FY 8-1 2018.docx
Attachment N Social Marketing and PSE Descriptions from SNAP Plan Guidance FY 2018.docx
08/27/2018
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.