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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
WIC Participants - Individuals and Households
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 C6 Nutrition Services Observation Form
C6_Nutrition Services Observation Form_remote_4.6.21 .docx
No
Paper Only
Other-Appendix C8 WIC Participant Interview Guide
C8_WIC Participant Interview Guide_remote_4.6.21.docx
Yes
No
Paper Only
Other-Appendix C8a WIC Participant Interview Guide - Spanish
C8a_WIC Participant Interview Guide-Spanish_remote_4.6.21.docx
Yes
No
Paper Only
Other-Appendix G8 WIC Participant Screener
G8_WIC Participant Screener.docx
Yes
No
Paper Only
Other-Appendix G8a WIC Participant Screener - Spanish
G8a_WIC Participant Screener-Spanish.docx
Yes
No
Paper Only
Other-Appendix G9 Informed Consent for Observation and WIC Participant Interview
G9_Informed Consent for Observation and WIC Participant Interview_remote_4.6.21.docx
Yes
No
Paper Only
Other-Appendix G9a Informed Consent for Observation and WIC Participant Interview - Spanish
G9a_Informed Consent for Observation and WIC Participant Interview-Spanish_remote.docx
Yes
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:
56 FR 19078
Number of Respondents:
512
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
2,642
0
2,642
0
0
0
Annual IC Time Burden (Hours)
242
0
242
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Appendix G7 Study Brochure for WIC Participant
G7_Study Brochure for WIC Participant.pdf
10/28/2020
Appendix G7a Study Brochure for WIC Participant - Spanish
G7a_Study Brochure for WIC Participant-Spanish.pdf
10/28/2020
Appendix G10 Reminder Text for WIC Participant Interview to be Conducted Over the Phone
G10_Reminder Text for WIC Participant Interview to be Conducted Over the Phone.docx
10/28/2020
Appendix G10a Reminder Text for WIC Participant Interview to be Conducted Over the Phone - Spanish
G10a_Reminder Text for WIC Participant Interview to be Conducted Over the Phone-Spanish.docx
10/28/2020
Appendix G11 Reminder Call for WIC Participant Interview to be Conducted Over the Phone
G11_Reminder Call for WIC Participant Interview to be Conducted Over the Phone.docx
10/28/2020
Appendix G11a Reminder Call for WIC Participant Interview to be Conducted Over the Phone - Spanish
G11a_Reminder Call for WIC Participant Interview to be Conducted Over the Phone-Spanish.docx
10/28/2020
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.