Information Collection

Individuals/Households SNAP Participants Respondents

IC 238962 under ICR 202105-0584-006 · OMB 0584-0659.

Documents and Forms

Document Name Document Type
L. SNAP Office Waiting Room Questionnaire_final_clean_final response to PRAO.docx Other-L. SNAP Office Waiting Room Qu
L. SNAP Office Waiting Room Questionnaire_final_clean_final response to PRAO.docx Other-L. SNAP Office Waiting Room Qu
K. SNAP Participants Focus Group Protocol revised.docx Other-K. SNAP Participants Focus Gro
K. SNAP Participants Focus Group Protocol revised.docx Other-K. SNAP Participants Focus Gro
N. SNAP Participants Focus Group Eligibility Screener revised.docx Other-N. SNAP Participants Focus Gro
N. SNAP Participants Focus Group Eligibility Screener revised.docx Other-N. SNAP Participants Focus Gro
O. SNAP Participants Focus Group Demographic Questionnaire Revised.docx Other-O. SNAP Participants Focus Gro
O. SNAP Participants Focus Group Demographic Questionnaire Revised.docx Other-O. SNAP Participants Focus Gro
P. Consent Form for Waiting Room Questionnaire Participants_final_clean_final response to PRAO.docx P. Consent Form for Waiting Room Questionnaire Participants_final_clean_final response to PRAO.docx IC Document
P. Consent Form for Waiting Room Questionnaire Participants_final_clean_final response to PRAO.docx P. Consent Form for Waiting Room Questionnaire Participants_final_clean_final response to PRAO.docx IC Document
Q. Consent Form for Focus Group With SNAP Participants revised.docx Q. Consent Form for Focus Group With SNAP Participants revised IC Document
Q. Consent Form for Focus Group With SNAP Participants revised.docx Q. Consent Form for Focus Group With SNAP Participants revised IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Individuals/Households SNAP Participants Respondents	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-L. SNAP Office Waiting Room Questionnaire_final_clean_final response to PRAO.docx	L. SNAP Office Waiting Room Questionnaire_final_clean_final response to PRAO.docx	No	Paper Only
Other-K. SNAP Participants Focus Group Protocol revised	K. SNAP Participants Focus Group Protocol revised.docx	No	Paper Only
Other-N. SNAP Participants Focus Group Eligibility Screener revised	N. SNAP Participants Focus Group Eligibility Screener revised.docx	No	Paper Only
Other-O. SNAP Participants Focus Group Demographic Questionnaire Revised	O. SNAP Participants Focus Group Demographic Questionnaire Revised.docx	No	Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title: USDA/FNS 10 Persons Doing Business with FNS	FR Citation: 65 FR 17251

Number of Respondents: 245	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	651	651
Annual IC Time Burden (Hours)	179	179
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
P. Consent Form for Waiting Room Questionnaire Participants_final_clean_final response to PRAO.docx	P. Consent Form for Waiting Room Questionnaire Participants_final_clean_final response to PRAO.docx	03/06/2020
Q. Consent Form for Focus Group With SNAP Participants revised	Q. Consent Form for Focus Group With SNAP Participants revised.docx	05/26/2021

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.