OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

State Agencies

IC 223534 under ICR 201606-0584-002 · OMB 0584-0622.

Documents and Forms
Document Name
Document Type
Other-Appendix C - SCRIPT FOR SURVEY
Other-Appendix D - Screenshots of Su
Other-Appendix J - Survey Pre-Test F
Other-Appendix B1 - State Agency Sur
Other-Appendix B2 - Local Agency Sur
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

State Agencies
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Appendix D - Screenshots of Survey Pre-Test Instrument Appendix D - Screenshots of Survey Pre-Test Instrument.pdf https://www.snapsurveys.com/wh/s.asp?k=145577273350. Yes Yes Fillable Fileable Signable
Other-Appendix J - Survey Pre-Test Feedback Form Appendix J - Survey Pre-Test Feedback Form.docx https://www.snapsurveys.com/wh/s.asp?k=145577273350. Yes Yes Fillable Fileable Signable
Other-Appendix B1 - State Agency Survey Instrument Appendix B1 - State Agency Survey Instrument.docx https://snapsurveys.com/wh/s.asp?=145577273350 Yes Yes Fillable Fileable Signable
Other-Appendix C - SCRIPT FOR SURVEY TELEPHONE INTERVIEW (FINAL) Appendix C - Script for Survey Telephone Interview (FINAL).docx Yes No Paper Only
Other-Appendix B2 - Local Agency Survey Instrument Appendix B2 - Local Agency Survey Instrument.docx https://snapsurveys.com/wh/s.asp?=145577273350 Yes Yes Fillable Fileable Signable

Income Security Food and Nutrition Assistance

 

360 0
   
State, Local, and Tribal Governments
 
   90 %

  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 360 0 360 0 0 0
Annual IC Time Burden (Hours) 536 0 536 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Appendix E1 - Letter Template from FNS Regional Office to State SNAP Director Appendix E1 - Letter Template from FNS Regional Office to State SNAP Director.docx 10/21/2016
Appendix E2 - Letter from Study Coordinator to State SNAP Director following FNS Regional Office Letter Appendix E2 - Letter from Study Coordinator to State SNAP Director following FNS Regional Office Letter.docx 10/21/2016
Appendix E3 - Letter Template from State SNAP Director to Local SNAP Agency Manager Appendix E3 - Letter Template from State SNAP Director to Local SNAP Agency Manager.docx 10/21/2016
Appendix E4 - Letter from Study Coordinator to Local SNAP Agency Manager Appendix E4 - Letter from Study Coordinator to Local SNAP Agency Manager.docx 10/21/2016
Appendix E5 - First Letter from Study Coordinator to Survey Non-Respondents Appendix E5 - First Letter from Study Coordinator to Survey Non-Respondents.docx 10/21/2016
Appendix E6 - Letter from FNS to State or Local SNAP Agency Regarding Non-Response Appendix E6 - Letter from FNS to State or Local SNAP Agency Regarding Non-Response.docx 10/21/2016
Appendix E7 - Second Letter from Study Coordinator to Survey Non-Respondents Appendix E7 - Second Letter from Study Coordinator to Survey Non-Respondents.docx 10/21/2016
Appendix E8 - Thank You Letter to Study Participants Appendix E8 - Thank You Letter to Study Participants.docx 10/21/2016
Appendix E9 - Study Information Sheet Attachment to Letters Appendix E9 - Study Information Sheet Attachment to Letters.docx 10/21/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.