OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Impact Evaluation Instruments - Households

IC 190543 under ICR 201201-0584-004 · OMB 0584-0554.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Appendix A Impact Evaluation Data Collecting Instrument MSUE 3 16 11.doc Other-Questionnaire - Michigan
Appendix A. Impact Evaluation Data Collecting Instrument UKCES 3.16.11.doc Other-Questionnaire - KY
Appendix A. Impact Evaluation Data Collecting Instruments INN 3.16.11.doc Other-Questionnaire - PA
APPENDIX A. Data Collection Instruments for Impact Evaluation INN Spanish Part 1.docx Other-Survey Instruments for the Iow
APPENDIX A. Data Collection Instruments for Impact Evaluation INN Spanish Part 2.docx Other-Survey: Instruments for the Io
APPENDIX A. Data Collection Instruments for Impact Evaluation INN English Part 3 1-3-2011 PRAB comments.docx Other-Survey: Instruments for the Io
APPENDIX A. Data Collection Instruments for Impact Evaluation INN Spanish Part 4.docx Other-Survey: Instruments for the Io
APPENDIX A. Data Collection Instruments for Impact Evaluation INN Spanish Part 5.docx Other-Survey: Instruments for the Io
Postcard_NewYear2012.pdf Other-NEW Postcard
APPENDIX H. Cover Letters, Recruitment Letters and other St SLO 2.1.11.docx
APPENDIX H. Households Cover Letters, Recruitment Letters and other		IC Document
APPENDIX E. Statistical Methods for Impact Evaluation_final.docx
APPENDIX E. Statistical Methods for Impact Evaluation		IC Document
APPENDIX F. Data Collection Methods for Impact Evaluation_f.docx
APPENDIX F. Data Collection Methods for Impact Evaluation		IC Document
APPENDIX H. Cover Letters, Recruitment Letters and other St SLO 2.1.11.docx
Appendix H - Cover Letters, Recruitment Letters and other		IC Document
APPENDIX E. Statistical Methods for Impact Evaluation_final.docx
APPENDIX E. Statistical Methods for Impact Evaluation		IC Document
APPENDIX F. Data Collection Methods for Impact Evaluation_f.docx
APPENDIX F. Data Collection Methods for Impact Evaluation		IC Document
OMB_Memo_PostCard (2) revised dec 2011 (2).doc
Change Justification Memo		IC Document
0554 SNAP Edu Wave II burden estimate table revised 2-1-12.xlsx
Revised Burden Estimate Table		IC Document
0554 Non-responses for SNAP Edu Wave II burden estimate table revised 2-1-12.xlsx
Non Respondent Burden		IC Document

Information Collection (IC) Details

View Information Collection (IC)

layout table

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-NEW Postcard Postcard_NewYear2012.pdf No   Paper Only
Other-Questionnaire - Michigan Appendix A Impact Evaluation Data Collecting Instrument MSUE 3 16 11.doc No   Paper Only
Other-Questionnaire - KY Appendix A. Impact Evaluation Data Collecting Instrument UKCES 3.16.11.doc No   Paper Only
Other-Questionnaire - PA Appendix A. Impact Evaluation Data Collecting Instruments INN 3.16.11.doc No   Paper Only
Other-Survey Instruments for the Iowa Nutrition Network Impact Evaluation�Spanish Version APPENDIX A. Data Collection Instruments for Impact Evaluation INN Spanish Part 1.docx No   Paper Only
Other-Survey: Instruments for the Iowa Nutrition Network Impact Evaluation�Spanish Version APPENDIX A. Data Collection Instruments for Impact Evaluation INN Spanish Part 2.docx No   Paper Only
Other-Survey: Instruments for the Iowa Nutrition Network Impact Evaluation�Spanish Version APPENDIX A. Data Collection Instruments for Impact Evaluation INN English Part 3 1-3-2011 PRAB comments.docx No   Paper Only
Other-Survey: Instruments for the Iowa Nutrition Network Impact Evaluation�Spanish Version APPENDIX A. Data Collection Instruments for Impact Evaluation INN Spanish Part 4.docx No   Paper Only
Other-Survey: Instruments for the Iowa Nutrition Network Impact Evaluation�Spanish Version APPENDIX A. Data Collection Instruments for Impact Evaluation INN Spanish Part 5.docx No   Paper Only

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  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 6,752 0 -739 0 0 7,491
Annual IC Time Burden (Hours) 1,640 0 86 0 0 1,554
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
APPENDIX H. Households Cover Letters, Recruitment Letters and other APPENDIX H. Cover Letters, Recruitment Letters and other St SLO 2.1.11.docx 03/02/2011
APPENDIX E. Statistical Methods for Impact Evaluation APPENDIX E. Statistical Methods for Impact Evaluation_final.docx 03/03/2011
APPENDIX F. Data Collection Methods for Impact Evaluation APPENDIX F. Data Collection Methods for Impact Evaluation_f.docx 03/03/2011
Appendix H - Cover Letters, Recruitment Letters and other APPENDIX H. Cover Letters, Recruitment Letters and other St SLO 2.1.11.docx 06/09/2011
APPENDIX E. Statistical Methods for Impact Evaluation APPENDIX E. Statistical Methods for Impact Evaluation_final.docx 06/09/2011
APPENDIX F. Data Collection Methods for Impact Evaluation APPENDIX F. Data Collection Methods for Impact Evaluation_f.docx 06/09/2011
Change Justification Memo OMB_Memo_PostCard (2) revised dec 2011 (2).doc 01/13/2012
Revised Burden Estimate Table 0554 SNAP Edu Wave II burden estimate table revised 2-1-12.xlsx 02/07/2012
Non Respondent Burden 0554 Non-responses for SNAP Edu Wave II burden estimate table revised 2-1-12.xlsx 02/07/2012
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.