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ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
WIC National Outreach Campaign Formative Focus Groups
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 A-1 WIC Par Screener (English) UPDATED
Attachment A-1 WIC Par Screener (English) UPDATED.docx
Yes
No
Fillable Printable
Other-Attachment A-2 WIC Non-Par Screener (English) UPDATED
Attachment A-2 WIC Non-Par Screener (English) UPDATED.docx
Yes
No
Fillable Printable
Other-Attachment A-3 WIC Par Screener (Spanish) UPDATED
Attachment A-3 WIC Par Screener (Spanish) UPDATED.docx
Yes
No
Fillable Printable
Other-Attachment A-4 WIC Non-Par Screener (Spanish) UPDATED
Attachment A-4 WIC Non-Par Screener (Spanish) UPDATED.docx
Yes
No
Fillable Printable
Other-Attachment B-1 Confirmation Form (English) UPDATED
Attachment B-1 Confirmation Form (English) UPDATED.docx
No
Paper Only
Other-Attachment B-2 Confirmation Form (Spanish) UPDATED
Attachment B-2 Confirmation Form (Spanish) UPDATED.docx
No
Paper Only
Other-Attachment C-1 Consent Form (English) UPDATED
Attachment C-1 Consent Form (English) UPDATED.docx
No
Paper Only
Other-Attachment C-2 Consent Form (Spanish) UPDATED
Attachment C-2 Consent Form (Spanish) UPDATED.docx
No
Paper Only
Other-Attachment D-1 WIC FG Guide Participants (English) UPDATED
Attachment D-1 WIC FG Guide Participants (English) UPDATED.docx
No
Paper Only
Other-Attachment D-2 WIC FG Guide NonParticipants (English) UPDATED
Attachment D-2 WIC FG Guide NonParticipants (English) UPDATED.docx
No
Paper Only
Other-Attachment D-3 WIC FG Guide Participants (Spanish) UPDATED
Attachment D-3 WIC FG Guide Participants (Spanish) UPDATED.docx
No
Paper Only
Other-Attachment D-4 WIC FG Guide NonParticipants (Spanish) UPDATED
Attachment D-4 WIC FG Guide NonParticipants (Spanish) UPDATED.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:
FR Citation:
Number of Respondents:
800
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
3,200
0
0
0
0
3,200
Annual IC Time Burden (Hours)
414
0
0
0
0
414
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Fast Track Clearance WIC National Outreach Campaign Formative FGs UPDATED_4_4_23
Fast Track Clearance WIC National Outreach Campaign Formative FGs UPDATED_4_4_23 .docx
04/05/2023
Attachment E-1 Determination Notice for Non Human Subjects Research
Attachment E-1 Determination Notice for Non Human Subjects Research.pdf
04/05/2023
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.