WIC Food Packages

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
0584-NEW WIC Food Pkg SS-InterimREV.doc	Supporting Statement A	Uploaded 2007-12-05	Available
#0584-NEW Burden WIC Food Pkg.xls	Supplementary Document	Uploaded 2007-10-21	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
44240	Maintain records of medical documentation		Unchanged
44238	Provide Medical Documentation		Modified

ICR Details

OMB Control No: 0584-0545	ICR Reference No: 200708-0584-006
Status: Historical Active	Previous ICR Reference No: 200607-0584-002
Agency/Subagency: USDA/FNS	Agency Tracking No:
Title: WIC Food Packages
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/07/2007
	Date Received in OIRA: 12/06/2007
Terms of Clearance: This ICR is approved, consistent with the WIC interim final rule it is associated with. FNS agrees to publish a separate notice in the Federal Register to notify the public that these burdens associated with the rule have been approved.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2010	36 Months From Approved
Responses	311,970	0	0
Time Burden (Hours)	14,919	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: To provide medical documentation to receive benefits of certain foods in WIC food packages.

---

Authorizing Statute(s): PL: Pub.L. 109 - 85 17 Name of Law: Child Nutrition Act of 1966
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0584-AD77	Final or interim final rulemaking	72 FR 68966	12/06/2007

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	71 FR 44784	08/07/2006
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Provide Medical Documentation
Maintain records of medical documentation

---

ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	311,970	0	0	311,970	0	0
Annual Time Burden (Hours)	14,919	0	0	14,919	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Changing Regulations

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is new collection of information.

---

Annual Cost to Federal Government: $3,160,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 12/06/2007

---