OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Usability testing of the Supplemental Nutrition Assistance Program addendum

IC 251000 under ICR 202008-0607-006 · OMB 0607-0978.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
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)

Usability testing of the Supplemental Nutrition Assistance Program addendum
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 Food Supplement Program-Paper Application Indiana_enclosure 3 Food Supplement Program-Paper Application Indiana_enclosure 3.pdf No   Fillable Fileable
Form and Instruction 2 Food Supplement Program-Paper Application MA_enclosure 3 Food Supplement Program-Paper Application MA_enclosure 3.pdf No   Fillable Fileable
Form and Instruction 3 Food Supplement Program-Paper Application MD_enclosure 3 Food Supplement Program-Paper Application MD_enclosure 3.pdf No   Fillable Fileable
Form and Instruction 4 Food Supplement Program-Paper Application Oklahoma_enclosure 3 Food Supplement Program-Paper Application Oklahoma_enclosure 3.pdf No   Fillable Fileable
Form and Instruction 5 Food Supplement Program-Paper Application VA_enclosure 3 Food Supplement Program-Paper Application VA_enclosure 3.pdf No   Fillable Fileable

General Government Central Records & Statistical Mgt

 

1 0
   
Individuals or Households
 
   0 %

  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 0 1 0 0 0
Annual IC Time Burden (Hours) 0 0 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
OMB Letter OMB letter_fns_addendum_01_03_22_clean.docx 01/03/2022
Original OMB Letter approved oct 18 2019 omb letter_fns_ORIGINAL request_enclosure 1.docx 01/03/2022
Protocol protocol _enclosure 2.docx 01/03/2022
Demographic Questionnaire demographic questionnaire enclosure 4.docx 01/03/2022
Mobile devise use questionnaire Mobile devise use questionnaire_enclosure 5.docx 01/03/2022
Satisfaction questionnaire Satisfaction questionnaire_enclosure 6.docx 01/03/2022
Usability Test Plan FNS - Usability Test Plan 8.19.19_enclosure 8_OMB_elo.docx 01/31/2022
Consent form consent form_enclosure 9_clean.docx 01/03/2022
Additional screener questions additional screener question enclosure 7_OMB_elo.docx 01/31/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.