OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Respondents- Individuals/Households (Parents/Children/Teens)

IC 229043 under ICR 201711-0584-003 · OMB 0584-0635.

Documents and Forms
Document Name
Document Type
Other-G2. Household Eligibility Scre
Other-G2.A Household Eligibility Scr
Other-G6. Telephone Follow-Up Script
Other-G7. Caregiver Survey.docx
Other-G7.A Caregiver Survey web.docx
Other-G8. Child Participant Survey.d
Other-G8.A Child Participant Survey
Other-G9. Teen Survey.docx
Other-G9.A Teen Survey web.docx
Other-G11. Telephone Script to Sched
Other-G12. Participant Caregiver KII
Other-G13. Nonparticipant caregiver
Other-H7. Participant Caregiver Surv
Other-H8. Nonparticipant Caregiver S
Other-H9. Child Participant Survey P
Other-H10. Teen Participant Survey P
Other-H11. Teen Nonparticipant Surve
Other-H12. Participant Caregiver Key
Other-H13. Nonparticipant Caregiver
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Respondents- Individuals/Households (Parents/Children/Teens)
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-G7. Caregiver Survey.docx G7. Caregiver Survey_2.16.18.docx No   Paper Only
Other-H7. Participant Caregiver Survey and Screener Pretest Protocol.docx H7. Participant Caregiver Survey and Screener Pretest Protocol.docx No   Paper Only
Other-H8. Nonparticipant Caregiver Survey and Screener Pretest Protocol.docx H8. Nonparticipant Caregiver Survey and Screener Pretest Protocol.docx No   Paper Only
Other-H9. Child Participant Survey Pretest Protocol.docx H9. Child Participant Survey Pretest Protocol.docx No   Paper Only
Other-H10. Teen Participant Survey Pretest Protocol.docx H10. Teen Participant Survey Pretest Protocol.docx No   Paper Only
Other-H11. Teen Nonparticipant Survey Pretest Protocol.docx H11. Teen Nonparticipant Survey Pretest Protocol.docx No   Paper Only
Other-H12. Participant Caregiver Key Informant Interview Pretest Protocol.docx H12. Participant Caregiver Key Informant Interview Pretest Protocol.docx No   Paper Only
Other-H13. Nonparticipant Caregiver Key Informant Interview Pretest Protocol.docx H13. Nonparticipant Caregiver Key Informant Interview Pretest Protocol.docx No   Paper Only
Other-G2. Household Eligibility Screener.docx G2. Household Eligibility Screener.docx www.notyetcreated.com Yes Yes Fillable Fileable Signable
Other-G2.A Household Eligibility Screener web.docx G2.A Household Eligibility Screener web.docx www.notyetcreated.com Yes Yes Fillable Fileable Signable
Other-G6. Telephone Follow-Up Script for Caregivers.docx G6. Telephone Follow-Up Script for Caregivers.docx No   Paper Only
Other-G7.A Caregiver Survey web.docx G7.A Caregiver Survey web.docx www.notyetcreated.com Yes Yes Fillable Fileable Signable
Other-G8. Child Participant Survey.docx G8 Child survey.docx No   Paper Only
Other-G8.A Child Participant Survey web.docx G8.A Child Participant Survey web.docx www.notyetcreated.com Yes Yes Fillable Fileable Signable
Other-G9. Teen Survey.docx G9. Teen Survey.docx No   Paper Only
Other-G9.A Teen Survey web.docx G9.A Teen Survey web.docx www.notyetcreated.com Yes Yes Fillable Fileable Signable
Other-G11. Telephone Script to Schedule Caregiver Key Informant Interview.docx G11. Telephone Script to Schedule Caregiver Key Informant Interview.docx No   Paper Only
Other-G12. Participant Caregiver KII Discussion Guide.docx G12. Participant caregiver QI.docx No   Paper Only
Other-G13. Nonparticipant caregiver QI.docx G13. Nonparticipant caregiver QI.docx No   Paper Only

Income Security Food and Nutrition Assistance

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

24,568 0
   
Individuals or Households
 
   80 %

  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 230,855 0 230,855 0 0 0
Annual IC Time Burden (Hours) 16,504 0 16,504 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
G1. Household Screener Invitation Letter.docx G1. Household Screener Invitation Letter.docx 11/17/2017
G3. Invitation Letter for Mailed Surveys.docx G3. Invitation Letter for Mailed Surveys.docx 11/17/2017
G4. Reminder Postcard to Eligible Caregivers.docx G4. Reminder Postcard to Eligible Caregivers.docx 11/17/2017
G5. Invitation letter to onsite participants.docx G5. Invitation letter to onsite participants.docx 11/17/2017
G10. Study Thank You With Incentives (All Caregivers).docx G10. Study Thank You With Incentives (All Caregivers).docx 11/17/2017
G14. Key Informant Interview Thank You with Incentive (Caregivers).docx G14. Key Informant Interview Thank You with Incentive (Caregivers).docx 11/17/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.