View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	WIC Eligibility Customer Experience Survey	Agency IC Tracking Number:

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-WIC Eligibility Customer Experience Survey			Prescreening CX Survey Draft July 12.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: 22,500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 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	22,500	0	22,500	0	0	0
Annual IC Time Burden (Hours)	1,875	0	1,875	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Fast Track Submission - WIC Eligibility Customer Experience Survey	Fast Track Clearance Submission - WIC Eligibility Customer Experience Survey 7122024.docx	07/12/2024

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.