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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
SNAP E&T Program Participants (Individuals/Households) Respondents
Agency IC Tracking Number:
REVISED 2-27-19
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-Appendix A-5a Pretest Incoming Call Script Eligibility Prescreener Guide English 2-26-19.docx
Appendix A-5a Pretest Incoming Call Script Eligibility Prescreener Guide English_2_26_19.docx
No
Paper Only
Other-Appendix A-5b Pretest Incoming Call Script Eligibility Prescreener Guide Spanish_2_26_19.docx
Appendix A-5b Pretest Incoming Call Script Eligibility Prescreener Guide Spanish_2_26_19.docx
No
Paper Only
Other-Appendix A-6a_Survey of SNAP and Work CATI_English_2_26_19.docx
Appendix A-6a_Survey of SNAP and Work CATI_English_2_26_19.docx
CATI at Westat
Yes
Yes
Fillable Fileable
Other-Appendix A-6b_Survey of SNAP and Work CATI_Spanish_2_26_19.docx
Appendix A-6b_Survey of SNAP and Work CATI_Spanish_2_26_19.docx
CATI at Westat
Yes
Yes
Fillable Fileable
Other-Appendix A-6c Web Survey of SNAP and Work English_1_30_19.docx
Appendix A-6c Web Survey of SNAP and Work English_1_30_19.docx
www.fns.usda.gov
Yes
Yes
Fillable Fileable Signable
Other-Appendix A-6d Web Survey of SNAP and Work_Spanish_1_30_19.docx
Appendix A-6d Web Survey of SNAP and Work_Spanish_1_30_19.docx
www.fns.usda.gov
Yes
Yes
Fillable Fileable Signable
Other-Appendix A-6e Screen Shots--Web Survey of SNAP and Work--English_2_12_19.docx
Appendix A-6e Screen Shots--Web Survey of SNAP and Work--English_2_12_19.docx
www.fns.usda.gov
Yes
Yes
Fillable Fileable Signable
Other-Appendix A-6f Screen Shots--Web Survey of SNAP and Work--Spanish_2_12_19.docx
Appendix A-6f Screen Shots--Web Survey of SNAP and Work--Spanish_2_12_19.docx
www.fns.usda.gov
Yes
Yes
Fillable Fileable Signable
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:
56 FR 19078
Number of Respondents:
250
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
10 %
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
650
0
650
0
0
0
Annual IC Time Burden (Hours)
48
0
48
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Memo for Survey of SNAP and Work Generic ICR
Memo for Survey of SNAP and Work Generic Clearance Package_clean_2_26_19.docx
02/28/2019
Appendix A-1_Detailed burden table_2_27_19.xlsx
Appendix A-1_Detailed burden table_2_27_19.xlsx
03/04/2019
Appendix A-2a Pretest Craigslist Recruitment English CA_2_26_19.docx
Appendix A-2a Pretest Craigslist Recruitment English CA_2_26_19.docx
03/04/2019
Appendix A-2b Pretest Craigslist Recruitment Spanish CA_2_26_19.docx
Appendix A-2b Pretest Craigslist Recruitment Spanish CA_2_26_19.docx
03/04/2019
Appendix A-2c Pretest Craigslist Recruitment English DC_2_26_19.docx
Appendix A-2c Pretest Craigslist Recruitment English DC_2_26_19.docx
03/04/2019
Appendix A-3a Pretest Flyer English CA_2_26_19.docx
Appendix A-3a Pretest Flyer English CA_2_26_19.docx
03/04/2019
Appendix A-3b Pretest Flyer English DC_2_26_19.docx
Appendix A-3b Pretest Flyer English DC_2_26_19.docx
03/04/2019
Appendix A-3c Pretest Flyer Spanish CA_2_26_19.docx
Appendix A-3c Pretest Flyer Spanish CA_2_26_19.docx
03/04/2019
Appendix A-4a Filtered Database Recruitment English_2_26_19.docx
Appendix A-4a Filtered Database Recruitment English_2_26_19.docx
03/04/2019
Appendix A-7a Email to confirm pretest interview appointment English CA.docx
Appendix A-7a Email to confirm pretest interview appointment English CA.docx
03/04/2019
Appendix A-7b Email to confirm pretest interview appointment Spanish CA.docx
Appendix A-7b Email to confirm pretest interview appointment Spanish CA.docx
02/28/2019
Appendix A-7c Email to confirm pretest interview appointment English DC.docx
Appendix A-7c Email to confirm pretest interview appointment English DC.docx
02/28/2019
Appendix A-10a Pretest Incentive Receipt English_2_26_19.docx
Appendix A-10a Pretest Incentive Receipt English_2_26_19.docx
03/04/2019
Appendix A-10b Pretest Incentive Receipt Spanish 2-26-19.docx
Appendix A-10b Pretest Incentive Receipt Spanish_2_26_19.docx
03/04/2019
Appendix A-11_2-26-19 Statement of Confidentiality and Nondisclosure.docx
Appendix A-11_2-26-19 Statement of Confidentiality and Nondisclosure.docx
02/28/2019
Appendix A-12_2-26-19 IRB Approval.docx
Appendix A-12_2-26-19 IRB Approval.docx
02/28/2019
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.