Information Collection

Impact Evaluation Instruments

IC 190543 under ICR 200908-0584-004 · OMB 0584-0554.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0554 can be found here:

Documents and Forms

Document Name Document Type
APPENDIX A. Data Collection Instruments for Impact Evaluation-SNAP-Ed I-English_Spanish.doc Other-Questionnaire-English_Spanish

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Impact Evaluation Instruments	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Questionnaire-English_Spanish			APPENDIX A. Data Collection Instruments for Impact Evaluation-SNAP-Ed I-English_Spanish.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: 2,154	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	4,223	4,223
Annual IC Time Burden (Hours)	1,184	1,184
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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