Zero Income (I/H)

Generic Clearance to Conduct Formative Research

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0524 can be found here:

Documents and Forms

Document Name Document Type
Attachment A1 - Interview Guide - English.docx Other-Attachment A1 - Interview Guid
Attachment A2 - SPANISH INTERVIEW PROTOCOL FOR ZERO INCOME STUDY.docx Other-Attachment A2 - SPANISH INTERV
Attachment B - Participant Consent Form - 1-23-12.docx Other-Attachment B - Participant Con
Attachment B1 - Zero Income Participant Interview Consent Form Spanish - 1-26-12.docx Other-Attachment B1 - Zero Income Pa
Attachment E - recruitment - telelphone script for SNAP participant2 - 1-26-12.docx Other-Attachment E - recruitment - t
Attachment E1 - recruitment - telelphone script for SNAP participant2 - spanish - 1-26-12.docx Other-Attachment E1 - recruitment -
Zero Income Generic Clearance 11-21-11 PRA comments.docx Zero Income Generic Clearance 11-21-11 PRA comments IC Document

Information Collection (IC) Details

IC Title:	Zero Income (I/H)	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-Attachment A1 - Interview Guide - English	Attachment A1 - Interview Guide - English.docx	No	Paper Only
Other-Attachment A2 - SPANISH INTERVIEW PROTOCOL FOR ZERO INCOME STUDY	Attachment A2 - SPANISH INTERVIEW PROTOCOL FOR ZERO INCOME STUDY.docx	No	Paper Only
Other-Attachment B - Participant Consent Form - 1-23-12	Attachment B - Participant Consent Form - 1-23-12.docx	No	Paper Only
Other-Attachment B1 - Zero Income Participant Interview Consent Form Spanish - 1-26-12	Attachment B1 - Zero Income Participant Interview Consent Form Spanish - 1-26-12.docx	No	Paper Only
Other-Attachment E - recruitment - telelphone script for SNAP participant2 - 1-26-12	Attachment E - recruitment - telelphone script for SNAP participant2 - 1-26-12.docx	No	Paper Only
Other-Attachment E1 - recruitment - telelphone script for SNAP participant2 - spanish - 1-26-12	Attachment E1 - recruitment - telelphone script for SNAP participant2 - spanish - 1-26-12.docx	No	Paper Only

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title: USDA/FNS-8 Studies and Reports	FR Citation: 56 FR 19078

Number of Respondents: 200	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	250	250
Annual IC Time Burden (Hours)	60	60
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Zero Income Generic Clearance 11-21-11 PRA comments	Zero Income Generic Clearance 11-21-11 PRA comments.docx	01/26/2012

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