Information Collection

WIC Participants

IC 186830 under ICR 200809-0584-002 · OMB 0584-0551.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
WIC Participant Survey_10.16.08.doc	Other-Questionnaire
Brochure WIC Participant_10.16.08.doc Brochure for Participants	IC Document
Letter from LWAs to Selected Participants.10.16.08.doc Letter to Participants from LWA	IC Document
LW_ Letter from LWAs to Selected Participants 10 16 08_spa_final.doc Spanish Letter to Participants from LWA	IC Document
LW_Brochure WIC Participant_10 16 08_spa_final.doc Brochure for Participants (Spanish)	IC Document
LW_Participant_consent.10.16.08_spa_final.doc Participant Consent Form (Spanish)	IC Document
Participant_consent.10.16.08.doc Participant Consent Form	IC Document
LW_Participant_consent.10.16.08_spa_final.doc Participant Consent Form (Spanish)	IC Document
Recruit LWA letter.10.16.08.doc Recruitment Letter to Sampled LWA	IC Document
Abt follow-up letter to State Agencies.10.16.08.doc Abt follow-up letter to State Agencies	IC Document

IC Title:

WIC Participants

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 7 CFR 247.19

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Questionnaire					No		Paper Only

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title: FNS Studies and Reports

FR Citation: 56 FR 19078

Number of Respondents: 1,280

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	1,280	1,280
Annual IC Time Burden (Hours)	640	640
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Brochure for Participants		10/16/2008
Letter to Participants from LWA		10/16/2008
Spanish Letter to Participants from LWA		10/16/2008
Brochure for Participants (Spanish)		10/16/2008
Participant Consent Form (Spanish)		10/16/2008
Participant Consent Form		10/16/2008
Participant Consent Form (Spanish)		10/16/2008
Recruitment Letter to Sampled LWA		10/16/2008
Abt follow-up letter to State Agencies		10/16/2008

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

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].