Information Collection

State Director Survey 2013

IC 196904 under ICR 201301-0584-004 · OMB 0584-0562.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0562 can be found here:

Documents and Forms

Document Name Document Type
Appendix E State Director Survey_2012.docx Other-State Director Survey 2013
Appendix D1 CN Invitation Letter.docx Appendix D1 CN Invitation Letter IC Document
Appendix D2 State CN Follow-up Email.docx Appendix D2 State CN Follow-up Email IC Document
Appendix D3 State CN Telephone Interviewer Script.docx Appendix D3 State CN Telephone Interviewer Script IC Document
Appendix D4 CN Thank you Postcard.docx Appendix D4 CN Thank you Postcard IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	State Director Survey 2013	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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-State Director Survey 2013			Appendix E State Director Survey_2012.docx		No		Paper Only

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 53	Number of Respondents for Small Entity: 1

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	153	-1,410	1,563
Annual IC Time Burden (Hours)	112	-2,631	2,743
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Appendix D1 CN Invitation Letter	Appendix D1 CN Invitation Letter.docx	02/05/2013
Appendix D2 State CN Follow-up Email	Appendix D2 State CN Follow-up Email.docx	02/05/2013
Appendix D3 State CN Telephone Interviewer Script	Appendix D3 State CN Telephone Interviewer Script.docx	02/05/2013
Appendix D4 CN Thank you Postcard	Appendix D4 CN Thank you Postcard.docx	02/05/2013

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