WIC NE State & Local - Phase II

WIC Nutrition Education Study

Documents and Forms

Document Name Document Type
PPP.1_NE Web Survey.docx Other-PPP.1_NE Web Survey
PPP.2_NE Paper Survey.docx Other-PPP.2_NE Paper Survey.docx
PPP.3_NE Survey SampleScreenshots.docx Other-PPP.3_NE Survey SampleScreensh
T_Phase II SA Invite Script.docx Other-T_Phase II SA Invite Script.do
TTT_Site Staff Interview Guide.docx Other-TTT_Site Staff Interview Guide
UUU_Site Staff Interview Guide.docx Other-UUU_Site Staff Interview Guide
V_Phase II LA Invite ScriptEdited.doc Other-V_Phase II LA Invite Script.do
XXX. Admin Data Request.docx Other-XXX. Admin Data Request.docx
QQQ_NE Info SheetEdited.docx QQQ_NE Info SheetEdited.docx IC Document
RRR_NE ThankUEdited.docx RRR_NE ThankUEdited.docx IC Document
S_Phase II SA Email Announce.docx S_Phase II SA Email Announce.docx IC Document
W_Phase II FAQ.docx W_Phase II FAQ.docx IC Document
SSS_NE Reminder CallEdited.docx SSS_NE Reminder CallEdited.docx IC Document
U_Phase II LA Email Announce.docx U_Phase II LA Email Announce.docx IC Document
VVV_Site Staff Intv Base Script.docx VVV_Site Staff Intv Base Script.docx IC Document
WWW_ Site Staff Intv Intrm Final Email.docx WWW_ Site Staff Intv Intrm Final Email.docx IC Document

Information Collection (IC) Details

IC Title:	WIC NE State & Local - Phase II	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-PPP.1_NE Web Survey	PPP.1_NE Web Survey.docx	Yes	Yes	Fillable Fileable
Other-PPP.2_NE Paper Survey.docx	PPP.2_NE Paper Survey.docx	No		Paper Only
Other-PPP.3_NE Survey SampleScreenshots.docx	PPP.3_NE Survey SampleScreenshots.docx	Yes	Yes	Fillable Fileable
Other-T_Phase II SA Invite Script.docx	T_Phase II SA Invite Script.docx	No		Paper Only
Other-TTT_Site Staff Interview Guide.docx	TTT_Site Staff Interview Guide.docx	No		Paper Only
Other-UUU_Site Staff Interview Guide.docx	UUU_Site Staff Interview Guide.docx	No		Paper Only
Other-V_Phase II LA Invite Script.doc	V_Phase II LA Invite ScriptEdited.doc	No		Paper Only
Other-XXX. Admin Data Request.docx	XXX. Admin Data Request.docx	No		Paper Only

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title: FNS-8 FNS Studies and Reports	FR Citation: 56 FR 19078

Number of Respondents: 66	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 83 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	46	46
Annual IC Time Burden (Hours)	17	17
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
QQQ_NE Info SheetEdited.docx	QQQ_NE Info SheetEdited.docx	06/28/2014
RRR_NE ThankUEdited.docx	RRR_NE ThankUEdited.docx	06/28/2014
S_Phase II SA Email Announce.docx	S_Phase II SA Email Announce.docx	06/28/2014
W_Phase II FAQ.docx	W_Phase II FAQ.docx	07/22/2014
SSS_NE Reminder CallEdited.docx	SSS_NE Reminder CallEdited.docx	06/28/2014
U_Phase II LA Email Announce.docx	U_Phase II LA Email Announce.docx	06/28/2014
VVV_Site Staff Intv Base Script.docx	VVV_Site Staff Intv Base Script.docx	06/28/2014
WWW_ Site Staff Intv Intrm Final Email.docx	WWW_ Site Staff Intv Intrm Final Email.docx	06/28/2014

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