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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
State, Local or Tribal Government
Agency IC Tracking Number:
Is this a Common Form?
No
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-Appendix C. Final State and Local SNAP Administrator Interview Guide
Appendix C. Final State and Local SNAP Administrator Interview Guide.docx
No
Paper Only
Other-Appendix D. Final State SNAP Eligibility Workers Interview Guide
Appendix D. Final State SNAP Eligibility Workers Interview Guide.docx
No
Paper Only
Other-Appendix G. Informed Consent Form
Appendix G. Informed Consent Form.docx
No
Paper Only
Other-Appendix H. Observation Guide
Appendix H. Observation Guide.docx
No
Paper Only
Other-Appendix L. Survey Recruitment Email
Appendix L. Survey Recruitment Email.docx
Yes
No
Printable Only
Other-Appendix M. Survey Invitation Email
Appendix M. Survey Invitation Email.docx
Yes
No
Printable Only
Other-Appendix T. Case Study Recruitment Email from FNS
Appendix T. Case Study Recruitment Email from FNS.docx
Yes
No
Printable Only
Other-Appendix U. Case Study Recruitment Email from Project Team
Appendix U. Case Study Recruitment Email from Project Team.docx
Yes
No
Printable Only
Other-Appendix F. Informed Consent Script for Interviews
Appendix F. Informed Consent Script for Interviews.docx
No
Paper Only
Other-Appendix B. Final State SNAP Agency Survey Instrument
Appendix B. Final State SNAP Agency Survey Instrument.docx
Yes
Yes
Fillable Printable
Other-Appendix I. List of Requested Administrative Data Elements
Appendix I. List of Requested Administrative Data Elements.docx
No
Paper Only
Other-Appendix K. Web Survey
Appendix K. Web Survey.pdf
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:
296
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
55 %
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
935
0
935
0
0
0
Annual IC Time Burden (Hours)
310
0
310
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Appendix O. Survey Thank You Email
Appendix O. Survey Thank You Email.docx
05/26/2022
Appendix P. Survey Reminder Email for Partial Completers
Appendix P. Survey Reminder Email for Partial Completers.docx
05/26/2022
Appendix Q. Survey Reminder Email for Non-Completers
Appendix Q. Survey Reminder Email for Non-Completers.docx
05/26/2022
Appendix R. Survey Reminder for Uploading Non-Public Documents
Appendix R. Survey Reminder for Uploading Non-Public Documents.docx
05/26/2022
Appendix S. Final Survey Reminder Email
Appendix S. Final Survey Reminder Email.docx
05/26/2022
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.