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Agenda
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ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
WIC Outreach Campaign – Campaign Logo and Platform Concept 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 Screener - English
Attachment A-1 WIC Screener (English)_050724.docx
Yes
Yes
Fillable Printable
Other-Attachment A-2 WIC Eligible Screener - English
Attachment A-2 WIC Eligible Screener (English) 050724.docx
Yes
Yes
Fillable Printable
Other-Attachment A-3 WIC Screener - Spanish
Attachment A-3 WIC Screener (Spanish) 050724.docx
Yes
Yes
Fillable Printable
Other-Attachment A-4 WIC Eligibility Screener - Spanish
Attachment A-4 WIC Eligible Screener (Spanish) 050724.docx
Yes
Yes
Fillable Printable
Other-Attachment C-1 Consent Form - English
Attachment C-1 Consent Form (English) -1.docx
Yes
Yes
Fillable Printable
Other-Attachment C-2 Consent Form - Spanish
Attachment C-2 Consent Form (Spanish) -1.docx
Yes
Yes
Fillable Printable
Other-Attachment D-1 WIC Focus Group Guide -English
Attachment D-1 WIC Platform Logo FG Guide (English) -1.docx
Yes
Yes
Fillable Printable
Other-Attachment D-2 WIC Platform Logo FG Guide Spanish
Attachment D-2 WIC Platform Logo FG Guide (Spanish)-1.docx
Yes
Yes
Fillable Printable
Other-F-1 Stimuli for Focus Groups
Attachment F-1 2.1.1.3 WIC Program Logos for Testing.pptx
Yes
Yes
Fillable Printable
Other-B-1 Confirmation Form (English)
Attachment B-1 Confirmation Form (English) -1.docx
Yes
Yes
Fillable Printable
Other-B-2 Confirmation Form (Spanish)
Attachment B-2 Confirmation Form (Spanish) -1.docx
Yes
Yes
Fillable Printable
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:
360
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
360
0
0
0
0
360
Annual IC Time Burden (Hours)
186
0
0
0
0
186
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
E-1 IRB Determination Notice
Attachment E-1 Determination Notice for Non Human Subjects Research (WIC - Logo and Platform Testing FGs).pdf
05/07/2024
WIC Outreach Campaign – Campaign Logo and Platform Concept Focus Groups
Fast Track Clearance WIC National Outreach Campaign Logo and Platform FGs_040524 -1.docx
05/07/2024
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.