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DGA 2020-2025 Survey and Focus Group (English and Spanish)
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Attachment A-1 Screener (English) (Pregnant Women 8-11-2020) Attachment A-1 Screener (English) clean OCIO 081120.docx www.notyetcreated.com Yes Yes Fillable Fileable Signable
Other-Attachment A-2 Discussion Guide (English) (Pregnant Women 8-11-2020) Attachment A-2 Discussion Guide (English) clean OCIO 081120.docx www.notyetcreated.com Yes Yes Fillable Fileable Signable
Other-Attachment A-3 Confirmation Form for Focus Group Participants (English 8-11-2020) Attachment A-3 Confirmation Form (English) clean OCIO 081120.docx Via email addresses Yes No Fillable Fileable Signable
Other-Attachment A-4 Consent Form (English).docx Attachment A-4 Consent Form (English).docx Via email addresses No   Fillable Fileable Signable
Other-Attachment A-7 Focus Group Public Burden Statement (English).docx Attachment A-7 Focus Group Public Burden Statement (English).docx www.notyetcreated.com Yes Yes Fillable Fileable Signable
Other-Attachment A-7a Survey Public Burden Statement (English).docx Attachment A-7a Survey Public Burden Statement (English).docx www.notyetcreated.com Yes Yes Fillable Fileable Signable
Other-Attachment A-8 Survey Questionnaire (English 8-10-2020).docx Attachment A-8 Survey Questionnaire (English) clean OCIO 081020.docx www.notyetcreated.com Yes Yes Fillable Fileable Signable
Other-Attachment A-9 Survey Invitation (English 8-11-2020) Attachment A-9 Survey Invitation (English) clean OCIO 081120.docx www.notyetcreated.com Yes Yes Fillable Fileable Signable
Other-Attachment A-10 Survey Screen Shots (English) Attachment A-10 Survey Screen Shots (English).pptx www.notyetcreated.com Yes Yes Fillable Fileable Signable
Other-Attachment C-1 Screener (English) (B-24 Caregiver Audience 8-11-2020) Attachment C-1 Screener (English) clean OCIO 081020.docx www.notyetcreated.com Yes Yes Fillable Fileable Signable
Other-Attachment C-2 Discussion Guide (English) (B-24 Caregiver Audience 8-11-2020) Attachment C-2 Discussion Guide (English) clean OCIO 081120.docx www.notyetcreated.com Yes Yes Fillable Fileable Signable
Other-Attachment E-1 Focus Group Screener (English) (Remaining Consumer Audiences 8-11-2020) Attachment E-1 Screener (English) clean OCIO 081120.docx www.notyetcreated.com Yes Yes Fillable Fileable Signable
Other- Attachment E-2 Discussion Guide (English) (Remaining Consumer Audiences 8-11-2020) Attachment E-2 Discussion Guide (English) clean OCIO 081120 (v1).docx www.notyetcreated.com Yes Yes Fillable Fileable Signable
Other-Attachment B-1 Screener (Spanish) (Pregnant Women) B-1 Screener (Spanish) clean OCIO 081120.docx www.notyetcreated.com Yes Yes Fillable Fileable Signable
Other-Attachment B-2 Discussion Guide (Spanish) (Pregnant Women) B-2 Discussion Guide (Spanish) clean OCIO 081120.docx www.notyetcreated.com Yes Yes Fillable Fileable Signable
Other-Attachment B-3 Confirmation Form for Focus Group Participants (Spanish) B-3 Confirmation Form (Spanish) clean OCIO 081120.docx Via email address Yes No Fillable Fileable Signable
Other-Attachment B-4 Consent Form (Spanish) B-4 Consent Form (Spanish) clean OCIO 081120.docx via e-mail address No   Fillable Fileable Signable
Other-Attachment B-7 Focus Group Public Burden Statement (Spanish) B-7 Focus Group Public Burden Statement (Spanish).docx www.notyetcreated.com Yes Yes Fillable Fileable Signable
Other-Attachment B-7a Survey Public Burden Statement (Spanish) B-7a Survey Public Burden Statement (Spanish).docx www.notyetcreated.com Yes Yes Fillable Fileable Signable
Other-Attachment B-8 Survey Questionnaire (Spanish) B-8 Survey Questionnaire (Spanish) clean OCIO 081020.docx www.notyetcreated.com Yes Yes Fillable Fileable Signable
Other-Attachment B-9 Survey Invitation (Spanish) B-9 Survey Invitation (Spanish) clean OCIO 081120.docx www.notyetcreated.com Yes Yes Fillable Fileable Signable
Other-Attachment B-10 Survey Screen Shots (Spanish) Attachment B-10 Survey Screen Shots (Spanish).pptx www.notyetcreated.com Yes Yes Fillable Fileable Signable
Other-Attachment D-1 Screener (Spanish) (B-24 Caregiver Audience) D-1 Screener (Spanish) clean OCIO 081120.docx www.notyetcreated.com Yes Yes Fillable Fileable Signable
Other-Attachment D-2 Discussion Guide (Spanish) (B-24 Caregiver Audience) D-2 Discussion Guide (Spanish) clean OCIO 081120.docx www.notyetcreated.com Yes Yes Fillable Fileable Signable

Income Security Food and Nutrition Assistance

USDA/FNS 8 FNS Studies and Reports  56 FR 17251

29,040 0
   
Individuals or Households
 
   100 %

  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 29,456 0 29,456 0 0 0
Annual IC Time Burden (Hours) 5,968 0 5,968 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
DGC 2020-2025 OMB Memo Cover Memo_final clean OCIO 081020.docx 08/10/2020
Attachement 3 Burden Estimates Excel Chart Attachment E-3 Burden Estimates Excel Chart (English).xlsx 08/05/2020
Attachment A-5 Confidentiality Agreement (English) Attachment A-5 Confidentiality Agreement (English).docx 08/07/2020
Attachment B-5 Confidentiality Agreement (Spanish) B-5 Confidentiality Agreement (Spanish).docx 08/07/2020
Attachment A-6 Privacy Act Statement (English).docx Attachment A-6 Privacy Act Statement (English).docx 08/11/2020
Attachment B-6 Privacy Act Statement (Spanish) B-6 Privacy Act Statement (Spanish).docx 08/11/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.