OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

State & Local SNAP or Medicaid Administrators and Staff

IC 207463 under ICR 201306-0584-001 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Appendix A-1 - First Round Instruments Recruitment Script Telephone and Email Revised 6.10.13.docx Other-Appendix A-1 - First Round Ins
Appendix A-2 - First Round Instruments Reminder Script Revised 6.10.13.docx Other-Appendix A-2 - First Round Ins
Appendix A-3 - First Round Intstruments Interview Guide State SNAP Administrators Revised 11.4.13.docx Other-Appendix A-3 - First Round Int
Appendix A-4 - First Round Instruments Interview Guide State Medicaid Administrators Revised 11.4.13.docx Other-Appendix A-4 - First Round Ins
Appendix A-5 - First Round Instruments Interview Guide Local SNAP Administrators and Staff Revised 11.4.13.docx Other-Appendix A-5 - First Round Ins
Appendix A-6 - First Round Instruments Interview Guide Local Medicaid Administrators and Staff Revised 11.4.13.docx Other-Appendix A-6 - First Round Ins
Appendix A-8 - First Round Instruments Thank You Email Revised 6.10.13.docx Other-Appendix A-8 - First Round Ins
Appendix B-1 - Second Round Instruments Recruitment Script Telephone and Email Revised 6.10.13.docx Other-Appendix B-1 - Second Round In
Appendix B-2 - Second Round Instruments Reminder Script Revised 6.10.13.docx Other-Appendix B-2 - Second Round In
Appendix B-3 - Second Round Instruments Interview Guide State SNAP Administrators Revised 11.4.13.docx Other-Appendix B-3 - Second Round In
Appendix B-4 - Second Round Instruments Interview Guide State Medicaid Administrators Revised 11.4.13.docx Other-Appendix B-4 - Second Round In
Appendix B-5 - Second Round Instruments Interview Guide Local SNAP Administrators and Staff Revised 11.4.13.docx Other-Appendix B-5 - Second Round In
Appendix B-6 - Second Round Instruments Interview Guide Local Medicaid Administrators and Staff Revised 11.4.13.docx Other-Appendix B-6 - Second Round In
Appendix B-8 - Second Round Instruments Thank You Email Revised 6.10.13.docx Other-Appendix B-8 - Second Round In
Appendix C-1 - Recruitment Letter for States with Linked Data Revised 11.4.13.docx Other-Appendix C-1 - Recruitment Let
Appendix C-2 - Recruitment Letter for States without Linked Data Revised 6.10.13.docx Other-Appendix C-2 - Recruitment Let
Appendix C-3 - Recruitment Attachment for States with Linked Data Revised 11.4.13.docx Other-Appendix C-3 - Recruitment Att
Appendix C-4 - Recruitment Attachment for States without Linked Data Revised 6.10.13.docx Other-Appendix C-4 - Recruitment Att

Information Collection (IC) Details

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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-Appendix A-1 - First Round Instruments Recruitment Script Telephone and Email Appendix A-1 - First Round Instruments Recruitment Script Telephone and Email Revised 6.10.13.docx No   Paper Only
Other-Appendix A-2 - First Round Instruments Reminder Script Appendix A-2 - First Round Instruments Reminder Script Revised 6.10.13.docx No   Paper Only
Other-Appendix A-3 - First Round Intstruments Interview Guide State SNAP Administrators Appendix A-3 - First Round Intstruments Interview Guide State SNAP Administrators Revised 11.4.13.docx No   Paper Only
Other-Appendix A-4 - First Round Instruments Interview Guide State Medicaid Administrators Appendix A-4 - First Round Instruments Interview Guide State Medicaid Administrators Revised 11.4.13.docx No   Paper Only
Other-Appendix A-5 - First Round Instruments Interview Guide Local SNAP Administrators and Staff Appendix A-5 - First Round Instruments Interview Guide Local SNAP Administrators and Staff Revised 11.4.13.docx No   Paper Only
Other-Appendix A-6 - First Round Instruments Interview Guide Local Medicaid Administrators and Staff Appendix A-6 - First Round Instruments Interview Guide Local Medicaid Administrators and Staff Revised 11.4.13.docx No   Paper Only
Other-Appendix A-8 - First Round Instruments Thank You Email Appendix A-8 - First Round Instruments Thank You Email Revised 6.10.13.docx No   Paper Only
Other-Appendix B-1 - Second Round Instruments Recruitment Script Telephone and Email Appendix B-1 - Second Round Instruments Recruitment Script Telephone and Email Revised 6.10.13.docx No   Paper Only
Other-Appendix B-2 - Second Round Instruments Reminder Script Appendix B-2 - Second Round Instruments Reminder Script Revised 6.10.13.docx No   Paper Only
Other-Appendix B-3 - Second Round Instruments Interview Guide State SNAP Administrators Appendix B-3 - Second Round Instruments Interview Guide State SNAP Administrators Revised 11.4.13.docx No   Paper Only
Other-Appendix B-4 - Second Round Instruments Interview Guide State Medicaid Administrators Appendix B-4 - Second Round Instruments Interview Guide State Medicaid Administrators Revised 11.4.13.docx No   Paper Only
Other-Appendix B-5 - Second Round Instruments Interview Guide Local SNAP Administrators and Staff Appendix B-5 - Second Round Instruments Interview Guide Local SNAP Administrators and Staff Revised 11.4.13.docx No   Paper Only
Other-Appendix B-6 - Second Round Instruments Interview Guide Local Medicaid Administrators and Staff Appendix B-6 - Second Round Instruments Interview Guide Local Medicaid Administrators and Staff Revised 11.4.13.docx No   Paper Only
Other-Appendix B-8 - Second Round Instruments Thank You Email Appendix B-8 - Second Round Instruments Thank You Email Revised 6.10.13.docx No   Paper Only
Other-Appendix C-1 - Recruitment Letter for States with Linked Data Appendix C-1 - Recruitment Letter for States with Linked Data Revised 11.4.13.docx No   Paper Only
Other-Appendix C-2 - Recruitment Letter for States without Linked Data Appendix C-2 - Recruitment Letter for States without Linked Data Revised 6.10.13.docx No   Paper Only
Other-Appendix C-3 - Recruitment Attachment for States with Linked Data Appendix C-3 - Recruitment Attachment for States with Linked Data Revised 11.4.13.docx No   Paper Only
Other-Appendix C-4 - Recruitment Attachment for States without Linked Data Appendix C-4 - Recruitment Attachment for States without Linked Data Revised 6.10.13.docx No   Printable Only

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  Requested 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 301 0 301 0 0 0
Annual IC Time Burden (Hours) 885 0 885 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
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.