Information Collection

State and Local WIC Staff (SLT)

IC 203582 under ICR 202204-0584-005 · OMB 0584-0580.

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: Unchanged

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	Previously Approved
Annual Number of Responses for this IC	2,101	2,101
Annual IC Time Burden (Hours)	2,029	2,029
Annual IC Cost Burden (Dollars)	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.