Information Collection

State and Local WIC Staff (SLT)

IC 203582 under ICR 202109-0584-001 · OMB 0584-0580.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0580 can be found here:

2022-04-28 - No material or nonsubstantive change to a currently approved collection

Documents and Forms

Document Name Document Type
App_H1.Year 9 HW measurement card - English.docx Other-App_H1.Year 9 HW measurement c
App_H1.Year 9 HW measurement card - English.docx Other-App_H1.Year 9 HW measurement c
App_H2.Year 9 HW measurement card - Spanish.docx Other-App_H2.Year 9 HW measurement c
App_H2.Year 9 HW measurement card - Spanish.docx Other-App_H2.Year 9 HW measurement c
App_R.Participant contact information request.docx Other-App_R.Participant contact info
App_R.Participant contact information request.docx Other-App_R.Participant contact info
App_N1. Announcement of study extension to WIC State agencies.docx App_N1. Announcement of study extension to WIC State agencies IC Document
App_N1. Announcement of study extension to WIC State agencies.docx App_N1. Announcement of study extension to WIC State agencies IC Document
App_N2 Announcement of study extension to WIC sites.docx App_N2 Announcement of study extension to WIC sites IC Document
App_N2 Announcement of study extension to WIC sites.docx App_N2 Announcement of study extension to WIC sites IC Document
App_O. Study extension webinar.pptx App_O. Study extension webinar IC Document
App_O. Study extension webinar.pptx App_O. Study extension webinar IC Document
App_P.Agenda for conference call on extension with State Agency and sites.docx App_P.Agenda for conference call on extension with State Agency and sites IC Document
App_P.Agenda for conference call on extension with State Agency and sites.docx App_P.Agenda for conference call on extension with State Agency and sites IC Document
App_Q1.Study extension summary and agreement_Correspondence to State Agency with copy to site POC.docx App_Q1.Study extension summary and agreement_Correspondence to State Agency with copy to site POC IC Document
App_Q1.Study extension summary and agreement_Correspondence to State Agency with copy to site POC.docx App_Q1.Study extension summary and agreement_Correspondence to State Agency with copy to site POC IC Document
App_Q2. Addendum A to study extension summary.docx App_Q2. Addendum A to study extension summary IC Document
App_Q2. Addendum A to study extension summary.docx App_Q2. Addendum A to study extension summary IC Document
App_Q3. Addendum B to Study Extension Summary.docx App_Q3. Addendum B to Study Extension Summary IC Document
App_Q3. Addendum B to Study Extension Summary.docx App_Q3. Addendum B to Study Extension Summary IC Document
App_S. Administrative data on Lost to Followup Participants.xlsx App_S. Administrative data on Lost to Followup Participants IC Document
App_S. Administrative data on Lost to Followup Participants.xlsx App_S. Administrative data on Lost to Followup Participants IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	State and Local WIC Staff (SLT)	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-App_H1.Year 9 HW measurement card - English	App_H1.Year 9 HW measurement card - English.docx	No	Paper Only
Other-App_H2.Year 9 HW measurement card - Spanish	App_H2.Year 9 HW measurement card - Spanish.docx	No	Paper Only
Other-App_R.Participant contact information request	App_R.Participant contact information request.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: FNS-8 USDA/FNS Studies and Reports	FR Citation: 56 FR 19078

Number of Respondents: 107	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	2,101	840	1,261
Annual IC Time Burden (Hours)	2,029	1,677	352
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
App_N1. Announcement of study extension to WIC State agencies	App_N1. Announcement of study extension to WIC State agencies.docx	10/27/2021
App_N2 Announcement of study extension to WIC sites	App_N2 Announcement of study extension to WIC sites.docx	10/27/2021
App_O. Study extension webinar	App_O. Study extension webinar.pptx	10/27/2021
App_P.Agenda for conference call on extension with State Agency and sites	App_P.Agenda for conference call on extension with State Agency and sites.docx	10/27/2021
App_Q1.Study extension summary and agreement_Correspondence to State Agency with copy to site POC	App_Q1.Study extension summary and agreement_Correspondence to State Agency with copy to site POC.docx	10/27/2021
App_Q2. Addendum A to study extension summary	App_Q2. Addendum A to study extension summary.docx	10/27/2021
App_Q3. Addendum B to Study Extension Summary	App_Q3. Addendum B to Study Extension Summary.docx	10/27/2021
App_S. Administrative data on Lost to Followup Participants	App_S. Administrative data on Lost to Followup Participants.xlsx	10/27/2021

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