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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Individuals/Households Respondents (including ages 60-69)
Agency IC Tracking Number:
Is this a Common Form?
No
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 O-1 Survey of SNAP and Work English Web
Appendix O-1 Survey of SNAP and Work English Web_5_11_21clean.docx
https://www.website forthcoming.com
Yes
Yes
Fillable Fileable Signable
Other-Appendix O-2 Survey of SNAP and Work Spanish Web.docx
Appendix O-2 Survey of SNAP and Work Spanish Web_5-18-21clean.docx
https://www.website forthcoming.com
Yes
Yes
Fillable Fileable Signable
Other-Appendix O-3 Screen Shots Survey of SNAP and Work English Web
Appendix O-3 Screen Shots -- Survey of SNAP and Work English Web_5_20_21.docx
https://www.website forthcoming.com
Yes
Yes
Fillable Fileable Signable
Other-Appendix O-4 Screen Shots Survey of SNAP and Work Spanish Web
Appendix O-4 Screen Shots -- Survey of SNAP and Work Spanish Web_5_20_21.docx
https://www.website forthcoming.com
Yes
Yes
Fillable Fileable Signable
Other-Appendix O-5 Survey of SNAP and Work English CATI
Appendix O-5 Survey of SNAP and Work English CATI_5_18_21clean.docx
https://www.website forthcoming.com
Yes
Yes
Fillable Fileable Signable
Other-Appendix O-6 Survey of SNAP and Work Spanish CATI
Appendix O-6 Survey of SNAP and Work Spanish CATI_5_18_21clean.docx
https://www.website forthcoming.com
Yes
Yes
Fillable Fileable Signable
Other-Appendix P-1 Telephone follow-up script English
Appendix P-1 Telephone follow-up script English_2_17_21clean.docx
https://www.website forthcoming.com
Yes
Yes
Fillable Fileable Signable
Other-Appendix P-2 Telephone follow-up script Spanish
Appendix P-2 Telephone follow-up script Spanish_4_14_21clean.docx
https://www.website forthcoming.com
Yes
Yes
Fillable Fileable Signable
Other-Appendix Q-1 Guidelines for in-person field recruitment English.docx
Appendix Q-1 Guidelines for in-person field recruitment English.docx
https://www.website forthcoming.com
Yes
Yes
Fillable Fileable Signable
Other-Appendix Q-2 Guidelines for in-person field recruitment Spanish
Appendix Q-2 Guidelines for in-person field recruitment Spanish.docx
https://www.website forthcoming.com
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:
USDA/FNS 8 FNS Studies and Reports
FR Citation:
56 FR 19078
Number of Respondents:
51,346
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
316,695
0
316,695
0
0
0
Annual IC Time Burden (Hours)
30,111
0
30,111
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Appendix H-1 Survey invitation letter English.docx
Appendix H-1 Survey invitation letter English_2_17_21clean.docx
05/27/2021
Appendix H-2 Survey invitation letter Spanish.docx
Appendix H-2 Survey invitation letter Spanish_4_13_21clean.docx
05/27/2021
Appendix I-1 Study brochure English.pdf
Appendix I-1 Study brochure English_4_14_21.pdf
05/27/2021
Appendix I-2 Study brochure Spanish
Appendix I-2 Study brochure Spanish_4_14_21.pdf
05/27/2021
Appendix J-1 Survey reminder postcard English
Appendix J-1 Survey reminder postcard English_2_17_21clean.docx
05/27/2021
Appendix J-2 Survey reminder postcard Spanish
Appendix J-2 Survey reminder postcard Spanish_4_13_21clean.docx
05/27/2021
Appendix K-1 Field locating letter English
Appendix K-1 Field locating letter English.docx
10/01/2020
Appendix K-2 Field locating letter Spanish
Appendix K-2 Field locating letter Spanish.docx
10/01/2020
Appendix K-2 Field locating letter Spanish.docx
Appendix L-1 Sorry I missed you card English.docx
10/01/2020
Appendix L-2 Sorry I missed you card Spanish
Appendix L-2 Sorry I missed you card Spanish.docx
10/01/2020
Appendix M-1 Thank you letter early response English
Appendix M-1 Thank you letter early response English.docx
10/01/2020
Appendix M-2 Thank you letter early response Spanish
Appendix M-2 Thank you letter early response Spanish.docx
10/01/2020
Appendix M-3 Thank you letter English
Appendix M-3 Thank you letter English_2_17_21clean.docx
05/27/2021
Appendix M-4 Thank you letter Spanish.docx
Appendix M-4 Thank you letter Spanish_4_13_21clean.docx
05/27/2021
Appendix H-3 Survey invitation letter English elderly 4_13_21
Appendix H-3 Survey invitation letter English_elderly 4_13_21.docx
05/27/2021
Appendix H-4 Survey invitation letter Spanish elderly 4_13_21
Appendix H-4 Survey invitation letter Spanish_elderly 4_13_21.docx
05/27/2021
Appendix J-3 Survey reminder letter English_4_13_2
Appendix J-3 Survey reminder letter English_4_13_2.docx
05/27/2021
Appendix J-4 Survey reminder letter Spanish_4_13_21
Appendix J-4 Survey reminder letter Spanish_4_13_21.docx
05/27/2021
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.