OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

SNAP work registrants and E&T program participants

IC 214460 under ICR 201512-0584-009 · OMB 0584-0602.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
INSTRUMENT 1_SNAP E&T R&P Survey_clean.docx Other-INSTRUMENT 1_SNAP E&T R&P Surv
INSTRUMENT 3_FG Participant Info Form_clean.docx Other-INSTRUMENT 3_FG Participant In
INSTRUMENT 4_FG Discussion Guide_clean.docx Other-INSTRUMENT 4_FG Discussion Mod
ATTACHMENT 11_FG Screening and Recruit Script_Response 11-26-14.docx Other-ATTACHMENT 11_FG Screening and
ATTACHMENT 12_FG ConfirmationLetter 1.6.2015.docx Other-ATTACHMENT 12_FG ConfirmationL
ATTACHMENT 13 FG_ConfirmationCallScript_Response 1.14.2015.docx Other-ATTACHMENT 13 FG_ConfirmationC
ATTACHMENT 14_FG Participant Consent Form_Response 1.14.2015.docx Other-ATTACHMENT 14_FG Participant C
INSTRUMENT 1.1_SNAP E&T R&P Survey web-based 1.12.2015.pdf Other-INSTRUMENT 1.1_SNAP E&T R&P Su
ATTACHMENT 1_R&P Survey Advance Letter_response 1.6.2015.docx
ATTACHMENT 1_R&P Survey Advance Letter_response 1.6.2015		IC Document
ATTACHMENT 2_R&P Survey Reminder Postcard_Response 11-26-14.docx
ATTACHMENT 2_R&P Survey Reminder Postcard_Response 11-26-14		IC Document
ATTACHMENT 3_RP Survey Reminder Letter 1_Response 1.06.2015.docx
ATTACHMENT 3_RP Survey Reminder Letter 1_Response 1.06.2015		IC Document
ATTACHMENT 4_E&T R&P Survey PreIncentive Letter_Response 1.06.2015.docx
ATTACHMENT 4_E&T R&P Survey PreIncentive Letter_Response 1.06.2015		IC Document
ATTACHMENT 5_R&P Survey Reminder Letter 2_Response 1.06.2015.docx
ATTACHMENT 5_R&P Survey Reminder Letter 2_Response 1.06.2015		IC Document
ATTACHMENT 6_R&P Survey Flyer_Response 11-26-14.docx
ATTACHMENT 6_R&P Survey Flyer_Response 11-26-14		IC Document
ATTACHMENT 7_R&P Survey thank you Letter_clean 1.06.2015.docx
ATTACHMENT 7_R&P Survey thank you Letter_clean 1.06.2015		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-INSTRUMENT 1_SNAP E&T R&P Survey_clean No   Paper Only
Other-INSTRUMENT 3_FG Participant Info Form_clean No   Paper Only
Other-INSTRUMENT 4_FG Discussion Moderator Guide_clean No   Paper Only
Other-ATTACHMENT 11_FG Screening and Recruit Script_Response 11-26-14 No   Paper Only
Other-ATTACHMENT 12_FG ConfirmationLetter 1.6.2015 No   Paper Only
Other-ATTACHMENT 13 FG_ConfirmationCallScript_Response 1.14.2015 No   Paper Only
Other-ATTACHMENT 14_FG Participant Consent Form_Response 1.14.2015 No   Paper Only
Other-INSTRUMENT 1.1_SNAP E&T R&P Survey web-based 1.12.2015 www.notyetcreated.com Yes Yes Fillable Fileable Signable

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 3,167 0 0 0 0 3,167
Annual IC Time Burden (Hours) 1,510 0 0 0 0 1,510
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
ATTACHMENT 1_R&P Survey Advance Letter_response 1.6.2015 01/16/2015
ATTACHMENT 2_R&P Survey Reminder Postcard_Response 11-26-14 12/30/2014
ATTACHMENT 3_RP Survey Reminder Letter 1_Response 1.06.2015 01/16/2015
ATTACHMENT 4_E&T R&P Survey PreIncentive Letter_Response 1.06.2015 01/16/2015
ATTACHMENT 5_R&P Survey Reminder Letter 2_Response 1.06.2015 01/16/2015
ATTACHMENT 6_R&P Survey Flyer_Response 11-26-14 12/30/2014
ATTACHMENT 7_R&P Survey thank you Letter_clean 1.06.2015 01/16/2015
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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