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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Evaluation of FY 2019 Summer Electronic Benefit Transfer (EBT) Demonstrations - Parents/Caregivers of Children (2 of 3)
Agency IC Tracking Number:
IC Status:
Unchanged
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 F.1 Focus Group Sign-In Sheet
Attachment F.1 Focus Group Sign-in Sheet.docx
No
Paper Only
Other-Attachment F.2 Focus Group Consent Form
Attachment F.2 Focus Group Consent Form.docx
No
Paper Only
Other-Attachment F.3 Parent/Caregiver Focus Group Interview Protocol
Attachment F.3 ParentCaregiver Focus Group Interview Protocol_25 Jun 2020.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 FNS Studies and Reports
FR Citation:
56 FR 19078
Number of Respondents:
480
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Requested
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
1,680
0
0
0
0
1,680
Annual IC Time Burden (Hours)
166
0
0
0
0
166
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Attachment A Burden Table
Attachment A Burden table 6.17.20.xlsx
06/18/2020
Attachment J IRB Approval
Attachment J IRB Approval.pdf
06/18/2020
Attachment G.1 Recruitment Flyer/Handout for Focus Group
Attachment G.1 Recruitment FlyerHandout for Focus Group_25 Jun 2020.docx
06/26/2020
Attachment G.2 Recruitment FAQ Sheet for Focus Groups
Attachment G.2 Recruitment FAQ Sheet for Focus Groups_25 Jun 2020.docx
06/26/2020
Attachment G.3 Study Overview Sheet for Focus Group Participants
Attachment G.3 Study Overview Sheet for Focus Group Participants_25 Jun ....docx
06/26/2020
Attachment G.4 Telephone Script for Focus Group Confirmation
Attachment G.4 Telephone Script for Focus Group Confirmation_25 Jun 2020.docx
06/26/2020
Attachment G.5 Focus Group Confirmation Email Template for Focus Group Participants
Attachment G.5 Focus Group Confirmation Email Template for Focus Group_25 Jun 2020.docx
06/26/2020
2019 Summer EBT Generic Submission 25 Jun 2020 Memo
2019 Summer EBT Generic Submission 25 Jun 2020 Memo.docx
06/26/2020
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.