View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

WIC Participant Diaries and IDIs
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-A-1 WIC Participant Screener (English) Yes Yes Fillable Printable
Other-A-2 WIC Participant Screener (Spanish) Yes Yes Fillable Printable
Other-B-1 Diary Confirmation Form (English) Yes Yes Fillable Printable
Other-B-2 Diary Confirmation Form (Spanish) Yes Yes Fillable Printable
Other-C-1 Diary Consent Form (English) Yes Yes Fillable Printable
Other-C-2 Diary Consent Form (Spanish) Yes Yes Fillable Printable
Other-D-1 WIC Participant Diary Activity List (English) Yes Yes Fillable Printable
Other-D-2 WIC Participant Diary Activity List (Spanish) Yes Yes Fillable Printable
Other-E-1 IDI Confirmation Form (English Yes Yes Fillable Printable
Other-E-2 IDI Confirmation Form (Spanish) Yes Yes Fillable Printable
Other-F-1 IDI Consent Form (English) Yes Yes Fillable Printable
Other-F-2 IDI Consent Form (Spanish) Yes Yes Fillable Printable
Other-G-1 WIC Participant In-Depth Interview (IDI) Moderator’s Guide (English) Yes Yes Fillable Printable
Other-G-2 WIC Participant In-Depth Interview (IDI) Moderator’s Guide (Spanish) Yes Yes Fillable Fileable

Income Security Food and Nutrition Assistance

 

720 0
   
Individuals or Households
 
   100 %

  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 720 0 0 0 0 720
Annual IC Time Burden (Hours) 225 0 0 0 0 225
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Fast Track Clearance WIC Shopping and Texting Research - Memo 12/04/2023
H-1 IRB Determination Notice 12/04/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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