Information Collection

SNAP Recipient Focus Groups (I/H)

IC 198716 under ICR 201107-0584-001 · OMB 0584-0564.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0564 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
FM Appendix F2 FG Participant Consent Form 11-7-13.docx	Other-Consent Form
FM Appendix F3 FG ParticipantDemographic survey 11-7-13.docx	Other-Participant Demographic Survey
Appendix F4 FM Shopper protocol 11-7-11.docx	Other-Moderator Script (FM shoppers)
FM Appendix F5 FG non shopper protocol 11-7-13.doc	Other-Moderator script (non-FM shopp
Appendix F6 FG Participant Incentive Receipt Form 11-7-13.docx	Other-Incentive Recipt
Appendix F4 FM Shopper protocol 11-7-11.docx	Other-Appendix F4 FM Shopper protoco
Appendix F1 Focus Group Recruitmnet Script 11 18 11.docx	Other-Appendix F1 Focus Group Recrui
Appendix F8 FG screened participant confirmation letter 11-10-11.docx Confirmation Letter	IC Document
Appendix F7 Focus Group recruitment flyer 11.10.11.docx Appendix F7 Focus Group recruitment flyer	IC Document

IC Title:

SNAP Recipient Focus Groups (I/H)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-Consent Form	FM Appendix F2 FG Participant Consent Form 11-7-13.docx	No	Paper Only
Other-Participant Demographic Survey	FM Appendix F3 FG ParticipantDemographic survey 11-7-13.docx	No	Paper Only
Other-Moderator script (non-FM shoppers)	FM Appendix F5 FG non shopper protocol 11-7-13.doc	No	Printable Only
Other-Appendix F4 FM Shopper protocol 11/17/2011	Appendix F4 FM Shopper protocol 11-7-11.docx	No	Paper Only
Other-Incentive Recipt	Appendix F6 FG Participant Incentive Receipt Form 11-7-13.docx	No	Paper Only
Other-Appendix F1 Focus Group Recruitment Script	Appendix F1 Focus Group Recruitmnet Script 11 18 11.docx	No	Paper Only
Other-Moderator Script (FM shoppers)	Appendix F4 FM Shopper protocol 11-7-11.docx	No	Printable Only

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title: FNS-8: USDA/FNS Studies and Reports

FR Citation: 65 FR 17251

Number of Respondents: 32

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	32	32
Annual IC Time Burden (Hours)	488	488
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Confirmation Letter	Appendix F8 FG screened participant confirmation letter 11-10-11.docx	11/18/2011
Appendix F7 Focus Group recruitment flyer	Appendix F7 Focus Group recruitment flyer 11.10.11.docx	11/18/2011

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