Information Collection

State & Local WIC Agencies

IC 186829 under ICR 200809-0584-002 · OMB 0584-0551.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
LWA Interview _P1_10.16.08.doc	Other-LWA Interview Pre-Implementati
LWA Interview_P2_10.16.08.doc	Other-LWA Interview Post Implementat
State Official Qs_P1_10.16.08.doc	Other-State Agency Pre-Implementatio
State Officials Qs_P2_10.16. 08.doc	Other-State Agency Post-Implementati
Abt followup letter to LWAs 9 22 08.doc Letter to Local WIC Agency	IC Document
Abt follow-up letter to State Agencies 9 22 08.doc Letter to State Agency	IC Document
Infosheet for state and local WIC agencies 9-22-08.doc Information Sheet for LWA & SA	IC Document
Recruit LWA letter 9 22 08.doc Recruitment Letter for LWA	IC Document
Recruit State_agency letter9 22 08.doc Recruitment Letter for SA	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 7 CFR 246.19

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-LWA Interview Pre-Implementation Questionnaire	LWA Interview _P1_10.16.08.doc	No	Paper Only
Other-LWA Interview Post Implementation Questionnaire	LWA Interview_P2_10.16.08.doc	No	Paper Only
Other-State Agency Pre-Implementation Interview Questionnaire	State Official Qs_P1_10.16.08.doc	No	Paper Only
Other-State Agency Post-Implementation Interview Questionnaire	State Officials Qs_P2_10.16. 08.doc	No	Paper Only

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 320

Number of Respondents for Small Entity: 32

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	320	320
Annual IC Time Burden (Hours)	384	384
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Letter to Local WIC Agency	Abt followup letter to LWAs 9 22 08.doc	10/06/2008
Letter to State Agency	Abt follow-up letter to State Agencies 9 22 08.doc	10/06/2008
Information Sheet for LWA & SA	Infosheet for state and local WIC agencies 9-22-08.doc	10/06/2008
Recruitment Letter for LWA	Recruit LWA letter 9 22 08.doc	10/06/2008
Recruitment Letter for SA	Recruit State_agency letter9 22 08.doc	10/06/2008

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