Information Collection

NSWP-III Pretest - SLT (IC 1 of 2)

IC 222223 under ICR 201503-0584-004 · OMB 0584-0606.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0606 can be found here:

2019-03-25 - Extension without change of a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix A1 Revised State Agency Survey - 071816.docx	Other-Appendix A1 Revised State Agen
Appendix A2 Revised Local WIC Agency Survey - 071816.docx	Other-Appendix A2 Revised Local WIC
B2. Revised Letter to State Agencies from Regional Offices.docx	Other-B2. Revised Letter to State Ag
B3. Revised State Agency Survey Invitation Email.docx	Other-B3. Revised State Agency Surve
B4. Revised State Agency Survey Invitation Letter with Instrument.docx	Other-B4. Revised State Agency Surve
B5. Revised State Agency Survey Reminder Email.docx	Other-B5. Revised State Agency Surve
B6. Revised State Agency Survey Reminder Phone Script.docx	Other-B6. Revised State Agency Surve
B7. Revised Local WIC Agency Survey Invitation Email.docx	Other-B7. Revised Local WIC Agency S
B8. Revised Local WIC Agency Survey Invitation Letter with Instrument.docx	Other-B8. Revised Local WIC Agency S
B9. Revised Local WIC Agency Survey Reminder Email.docx	Other-B9. Revised Local WIC Agency S
B10. Revised Local WIC Agency Survey Reminder Phone Script.docx	Other-B10. Revised Local WIC Agency
C3. Revised State Agency Survey Thank You Letter.docx	Other-C3. Revised State Agency Surve
C4. Revised Local WIC Agency Survey Thank You Letter.docx	Other-C4. Revised Local WIC Agency S
D1. State Agency Survey Debriefing Interview Guide.docx	Other-D1. State Agency Survey Debrie
D2. Local WIC Agency Debriefing Interview Guide.docx	Other-D2. Local WIC Agency Debriefin
071816 Generic 0584-0606_Pretesting for NSWP3.pdf OMB Memo - NSWP III	IC Document
B1. Revised Notification Email to Regional Offices - 071816.docx B1. Revised Notification Email to Regional Offices	IC Document
NSWP-III pretest burden table 7-18-16.xlsx NSWP III - Burden Table	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

NSWP-III Pretest - SLT (IC 1 of 2)

Agency IC Tracking Number:

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-B2. Revised Letter to State Agencies from Regional Offices	B2. Revised Letter to State Agencies from Regional Offices.docx	No	Paper Only
Other-B3. Revised State Agency Survey Invitation Email	B3. Revised State Agency Survey Invitation Email.docx	No	Paper Only
Other-B4. Revised State Agency Survey Invitation Letter with Instrument	B4. Revised State Agency Survey Invitation Letter with Instrument.docx	No	Paper Only
Other-B5. Revised State Agency Survey Reminder Email	B5. Revised State Agency Survey Reminder Email.docx	No	Paper Only
Other-B6. Revised State Agency Survey Reminder Phone Script	B6. Revised State Agency Survey Reminder Phone Script.docx	No	Paper Only
Other-B7. Revised Local WIC Agency Survey Invitation Email	B7. Revised Local WIC Agency Survey Invitation Email.docx	No	Paper Only
Other-B8. Revised Local WIC Agency Survey Invitation Letter with Instrument	B8. Revised Local WIC Agency Survey Invitation Letter with Instrument.docx	No	Paper Only
Other-B9. Revised Local WIC Agency Survey Reminder Email	B9. Revised Local WIC Agency Survey Reminder Email.docx	No	Paper Only
Other-B10. Revised Local WIC Agency Survey Reminder Phone Script	B10. Revised Local WIC Agency Survey Reminder Phone Script.docx	No	Paper Only
Other-C3. Revised State Agency Survey Thank You Letter	C3. Revised State Agency Survey Thank You Letter.docx	No	Paper Only
Other-C4. Revised Local WIC Agency Survey Thank You Letter	C4. Revised Local WIC Agency Survey Thank You Letter.docx	No	Paper Only
Other-D1. State Agency Survey Debriefing Interview Guide	D1. State Agency Survey Debriefing Interview Guide.docx	No	Paper Only
Other-D2. Local WIC Agency Debriefing Interview Guide	D2. Local WIC Agency Debriefing Interview Guide.docx	No	Paper Only
Other-Appendix A1 Revised State Agency Survey	Appendix A1 Revised State Agency Survey - 071816.docx	No	Paper Only
Other-Appendix A2 Revised Local WIC Agency Survey	Appendix A2 Revised Local WIC Agency Survey - 071816.docx	No	Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 27

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	181	181
Annual IC Time Burden (Hours)	27	27
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OMB Memo - NSWP III	071816 Generic 0584-0606_Pretesting for NSWP3.pdf	07/18/2016
B1. Revised Notification Email to Regional Offices	B1. Revised Notification Email to Regional Offices - 071816.docx	07/18/2016
NSWP III - Burden Table	NSWP-III pretest burden table 7-18-16.xlsx	07/18/2016

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