OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

State WIC Agency Officials (2020 and 2022)

IC 219981 under ICR 202006-0584-002 · OMB 0584-0609.

Documents and Forms
Document Name
Document Type
Other-Attachment H. Data Transmittal
Other-Appendix I. Nutritional Risk W
Other-Appendix J. Contact Request Fo
Other-Appendix M. Telephone Script f
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

State WIC Agency Officials (2020 and 2022)
 
No Modified
 
Mandatory
 
7 CFR 246.25(b)(3) 7 CFR 246.7(e)(4)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Attachment H. Data Transmittal Worksheet H. Data Transmittal Worksheet Revised 11.27.19.docx Yes Yes Fillable Fileable
Other-Appendix I. Nutritional Risk Worksheet I. Nutritional Risk Crosswalk.docx No   Paper Only
Other-Appendix J. Contact Request Form J. Contact Request Form.docx No   Paper Only
Other-Appendix M. Telephone Script for Follow-up Calls After Data Submission M. Telephone Script for Follow-up Calls After Data Submission.docx No   Paper Only

Income Security Food and Nutrition Assistance

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

360 34
   
State, Local, and Tribal Governments
 
   100 %

  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 1,392 0 0 0 0 1,392
Annual IC Time Burden (Hours) 629 0 0 0 0 629
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Appendix C. Notification Letter for Guidance to WIC State Agencies C. Notification Letter for Guidance to WIC State Agencies.docx 08/29/2019
Appendix D. Guidance for WIC State Agencies Providing Participant Data D. Guidance for WIC State Agencies Providing Participant Data Revised 11.27.19.docx 11/27/2019
Appendix K. Sample Reminder Email to WIC State Agencies K. Sample Reminder Email to WIC State Agencies.docx 08/29/2019
Appendix L. Sample Follow-Up Emal to State Agencies L. Sample Follow-Up Email to State Agencies.docx 06/11/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.