State & Local WIC Agencies

Evaluation of the Birth Month Breastfeeding Changes to the WIC Food Packages Study

Documents and Forms

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

Information Collection (IC) Details

IC Title:	State & Local WIC Agencies	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:

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 %

	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

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.