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Federal forms, ICRs, and supporting documents

Information Collection

WIC Child Retention (Private Sector) (2 of 2)

IC 237768 under ICR 201710-0584-003 · OMB 0584-0613.

Documents and Forms
Document Name
Document Type
Other-Pretest - Clinic Staff
Other-Email Request to WIC Local Age
Other-Reminder phone calls to WIC Lo
Other-Pretest - Local Agency
Other-Survey Reminder Phone Calls to
Other-Survey - WIC Child Retention (
Other-Survey - WIC Child Retention (
Other-Post-Survey Response Clarifica
Other-Post-Survey Response Clarifica
IC Document
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

WIC Child Retention (Private Sector) (2 of 2)
 
New
 
Voluntary
 
7 CFR 246

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Pretest - Clinic Staff A.3 Pretest-Clinic Staff .docx Yes No Printable Only
Other-Email Request to WIC Local Agency A.5 Email Request to WIC Local Agency 20200127.docx Yes Yes Printable Only
Other-Reminder phone calls to WIC Local Agency A.7 Reminder Phone Calls to WIC Local Agency 20200127.docx No   Paper Only
Other-Pretest - Local Agency A.2 Pretest-Local Agency.docx Yes No Fillable Fileable
Other-Survey Reminder Phone Calls to Clinic-Level Staff Member A.11 Survey Reminder Phone Calls to Clinic-Level Staff Member 20200127.docx No   Paper Only
Other-Survey - WIC Child Retention (web-based) A.9 Survey - WIC Child Retention 20200127.docx Yes Yes Fillable Fileable
Other-Survey - WIC Child Retention (screen shots) A.14 Survey - WIC Child Retention (Screenshots) 20200127.docx Yes Yes Fillable Fileable
Other-Post-Survey Response Clarification Phone Call A.12 Post-Survey Response Clarification Phone Call.docx No   Paper Only
Other-Post-Survey Response Clarification E-mail A.13 Post-Survey Response Clarification Email.docx Yes No Printable Only

Income Security Food and Nutrition Assistance

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

420 420
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   70 %

  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 2,503 0 2,503 0 0 0
Annual IC Time Burden (Hours) 334 0 334 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
QRS WIC Child Retention Burden Table A.1 QRS WIC Child Retention Burden Table FINAL 11.13.19.xlsx 11/13/2019
Reminder Emails to WIC Local Agency A.6 Reminder Emails to WIC Local Agency 20200127.docx 02/07/2020
Initial Survey Notification Email to Clinic-Level Staff Member A.8 Initial Survey Notification Email to Clinic-Level Staff Member 20200127.docx 02/07/2020
Survey Reminder Emails to Clinic-Level Staff member A.10 Survey Reminder Emails to Clinic-Level Staff Member 20200127.docx 02/07/2020
QRS WIC Child Retention Memo QRS WIC Retention_OMB Clearance Memo_20200103_Clean.docx 01/03/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.