State and Local Agencies

Healthy Incentives Pilot Evaluation

OMB: 0584-0561

IC ID: 197621

Documents and Forms
Document Name
Document Type
Other-Round 1 Massachusetts Executiv
Other-Round 2 Massachusetts Executiv
Other-Round 3 Massachusetts Executiv
Other-Round 1 DTA Staff HIP Intervie
Other-Round 2 DTA Staff HIP Intervie
Other-Round 3 DTA Staff HIP Intervie
Other-Round 1 DTA Technical Team HIP
Other-Round 2 DTA Technical Team HIP
Other-Round 3 DTA Technical Team HIP
Other-Round 1 Local Office Interview
Other-Round 2 Local Office Interview
Other-Round 3 Local Office Interview
Information Collection (IC) Details

View Information Collection (IC)

State and Local Agencies
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Round 1 Massachusetts Executive Interview Guide Appendix F1.docm No   Paper Only
Other-Round 2 Massachusetts Executive Interview Guide Appendix F2.docm No   Paper Only
Other-Round 3 Massachusetts Executive Interview Guide Appendix F3.docm No   Paper Only
Other-Round 1 DTA Staff HIP Interview Guide Appendix F4.docm No   Paper Only
Other-Round 2 DTA Staff HIP Interview Guide Appendix F5.docm No   Paper Only
Other-Round 3 DTA Staff HIP Interview Guide Appendix F6.docm No   Paper Only
Other-Round 1 DTA Technical Team HIP Interview Guide Appendix F7.docm No   Paper Only
Other-Round 2 DTA Technical Team HIP Interview Guide Appendix F8.docm No   Paper Only
Other-Round 3 DTA Technical Team HIP Interview Guide Appendix F9.docm No   Paper Only
Other-Round 1 Local Office Interview Guide Appendix F10.docm No   Paper Only
Other-Round 2 Local Office Interview Guide Appendix F11.docm No   Paper Only
Other-Round 3 Local Office Interview Guide Appendix F12.docm No   Paper Only

Income Security Food and Nutrition Assistance

 

17 0
   
State, Local, and Tribal Governments
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 17 0 17 0 0 0
Annual IC Time Burden (Hours) 24 0 24 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.

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