OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Elderly & Working Poor

IC 193210 under ICR 201005-0584-003 · OMB 0584-0558.

Documents and Forms
Document Name
Document Type
Other-Telephone Screener
Other-Telephone Screener
Other-Focus Group Guide
Other-Focus Group Guide - Spanish
Other-Recruitment Script Working Poo
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Elderly & Working Poor
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Recruitment Script Working Poor - Spanish Appendix F Recruitment Script Working Poor Spanish Final 10-5-2010.docx No   Paper Only
Other-Telephone Screener Appendix A Screener for Working Poor Final 10-5-2010.docx No   Paper Only
Other-Telephone Screener Appendix B Screener for Elderly Final 10-5-2010.docx No   Paper Only
Other-Focus Group Guide Appendix E Focus Group Discussion Protocol Final 10-5-2010.docx No   Paper Only
Other-Focus Group Guide - Spanish Appendix I Focus Group Protocol Spanish Final 10-5-2010.docx No   Paper Only

Income Security Food and Nutrition Assistance

 

1,200 0
   
Individuals or Households
 
   0 %

  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 1,200 0 1,200 0 0 0
Annual IC Time Burden (Hours) 195 0 195 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Reminder Telephone Script Appendix C Focus Group Reminder Letter 6-10-10.docx 06/10/2010
Reminder Call - Spanish Appendix D Focus Group Reminder Call.docx 06/09/2010
Reminder Letter - Spanish Appendix G Focus Group Reminder Letter Spanish.docx 06/10/2010
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.