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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Formative Quantitative Tracking Research for USDA MyPlate National Outreach Campaign
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-Attachment A-1: 2024 Survey (English) – includes Privacy Statement and Consent Form
Attachment A-1 2024 Survey (English).docx
Yes
Yes
Fillable Printable
Other-Attachment A-2: 2024 Survey (Spanish) – includes Privacy Statement and Consent Form
Attachment A-2 2024 Survey (Spanish).docx
Yes
Yes
Fillable Fileable
Other-Attachment A-3: 2024 Survey Screenshots (English)
Attachment A-3 2024 Survey Screenshots (English).docx
Yes
Yes
Fillable Printable
Other-Attachment A-4: 2024 Survey Screenshots (Spanish)
Attachment A-4 2024 Survey Screenshots (Spanish).docx
Yes
Yes
Fillable Printable
Other-Attachment A-5: 2024 Survey Stimuli 1 (English only)
Attachment A-5 2024 Survey Stimuli 1 (English only).mp4
Yes
Yes
Fillable Printable
Other-Attachment A-6: 2024 Survey Stimuli 2 (English only)
Attachment A-6 2024 Survey Stimuli 2 (English only).mp4
Yes
Yes
Fillable Printable
Other-Attachment A-7: 2024 Survey Stimuli 3 (English only)
Attachment A-7 2024 Survey Stimuli 3 (English only).mp4
Yes
Yes
Fillable Printable
Other-Attachment B-1: 2024 Survey Invitation (English)
Attachment B-1 2024 Survey Invitation (English).docx
Yes
Yes
Fillable Printable
Other-Attachment B-2: 2024 Survey Invitation (Spanish)
Attachment B-2 2024 Survey Invitation (Spanish).docx
Yes
Yes
Fillable Printable
Other-Attachment B-3: 2024 Survey Invitation (English version of Spanish invitation)
Attachment B-3 2024 Survey Invitation (English version of Spanish invitation).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:
10,667
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
13,867
0
13,867
0
0
0
Annual IC Time Burden (Hours)
1,536
0
1,536
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Attachment D-1: 2024 Determination Notice for Exempt Research
Attachment D-1 2024 Determination Notice for Exempt Research.pdf
09/25/2024
Attachment C-1: 2024 Confidentiality Form
Attachment C-1 2024 Confidentiality Form.docx
09/25/2024
OMB Generic Clearnce Memo CNPP
WIC Virtual Services_FAST_TRACK_CLEARANCE_FORM- 1.docx
11/04/2024
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.