OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Individuals/Households - Households

IC 226896 under ICR 201705-0584-004 · OMB 0584-0530.

Documents and Forms
Document Name
Document Type
Other-Appendix D3. Household Survey
Other-Appendix D4. Household Survey
Other-Appendix D5. Household Survey
Other-Appendix D6. Household Survey
Other-Appendix D9. Household Survey
Other-Appendix D10. Household Survey
Other-Appendix D13. Household Interv
Other-Appendix D14. Household Interv
Other-Appendix D15. Household Interv
Other-Appendix D16. Household Interv
Other-Appendix I1. Household Survey
Other-Appendix I2. Household Survey
Other-Appendix T5. Household Survey
Other-Appendix T6. Household Survey
Other-Appendix T7. Household Intervi
Other-Appendix T8. Household Intervi
IC Document
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)

Individuals/Households - Households
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Appendix D3. Household Survey Income Worksheet D03 Household Survey Income Worksheet.docx No   Paper Only
Other-Appendix D4. Household Survey Income Worksheet - Spanish D04 Household Survey Income Worksheet-Spanish.docx No   Paper Only
Other-Appendix D5. Household Survey D05 Household Survey_6.15.17.docx Yes Yes Fillable Fileable
Other-Appendix D6. Household Survey - Spanish D06 Household Survey-Spanish_6.15.17.docx Yes Yes Fillable Fileable
Other-Appendix D9. Household Survey Incentives Received Form D09 Household Survey Incentives Received Form.doc No   Paper Only
Other-Appendix D10. Household Survey Incentives Received Form - Spanish D10 Household Survey Incentives Received Form-Spanish.doc No   Paper Only
Other-Appendix D13. Household Interview D13 Household Interview.docx No   Paper Only
Other-Appendix D14. Household Interview - Spanish D14 Household Interview-Spanish.docx No   Paper Only
Other-Appendix D15. Household Interview Incentives Received Form D15 Household Interview Incentives Received Form.doc No   Paper Only
Other-Appendix D16. Household Interview Incentives Received Form - Spanish D16 Household Interview Incentives Received Form-Spanish.doc No   Paper Only
Other-Appendix I1. Household Survey Consent Form I01 Household Survey Consent Form.docx No   Paper Only
Other-Appendix I2. Household Survey Consent Form - Spanish I02 Household Survey Consent Form-Spanish.docx No   Paper Only
Other-Appendix T5. Household Survey Recruitment Contact Guide T05 Household Survey Recruitment Contact Guide.docx No   Paper Only
Other-Appendix T6. Household Survey Recruitment Contact Guide - Spanish T06 Household Survey Recruitment Contact Guide-Spanish.docx No   Paper Only
Other-Appendix T7. Household Interview Recruitment Contact Guide T07 Household Interview Recruitment Contact Guide.docx No   Paper Only
Other-Appendix T8. Household Interview Recruitment Contact Guide - Spanish T08 Household Interview Recruitment Contact Guide-Spanish.docx No   Paper Only

Income Security Food and Nutrition Assistance

FNS-8 USDA/FNS Studies and Reports  56 FR 19078

4,827 0
   
Individuals or Households
 
   99 %

  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 43,614 0 43,614 0 0 0
Annual IC Time Burden (Hours) 8,110 0 8,110 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Appendix D1. Household Survey Appointment Reminder Letter D01 Household Survey Appointment Reminder Letter.docx 05/17/2017
Appendix D2. Household Survey Appointment Reminder Letter - Spanish D02 Household Survey Appointment Reminder Letter-Spanish.docx 05/17/2017
Appendix D7. Household Survey Income Source Show Card D07 Household Survey Income Source Show Card.docx 05/17/2017
Appendix D8. Household Survey Income Source Show Card - Spanish D08 Household Survey Income Source Show Card-Spanish.docx 05/17/2017
Appendix D11. Household Interview Appointment Reminder Letter D11 Household Interview Appointment Reminder Letter.pdf 05/17/2017
Appendix D12. Household Interview Appointment Reminder Letter - Spanish D12 Household Interview Appointment Reminder Letter-Spanish.pdf 05/17/2017
Appendix T1. Household Survey Recruitment Letter T01 Household Survey Recruitment Letter.docx 05/18/2017
Appendix T2. Household Survey Recruitment Letter - Spanish T02 Household Survey Recruitment Letter-Spanish.docx 05/18/2017
Appendix T3. Household Survey Brochure T03 Household Survey Brochure.docx 05/18/2017
Appendix T4. Household Survey Brochure - Spanish T04 Household Survey Brochure-Spanish.docx 05/18/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.