OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

SNAP-Eligible Qualitative Research (Individuals/Households 18-75 years) Respondents + non-respondents

IC 232510 under ICR 201601-0584-002 · OMB 0584-0523.

Documents and Forms
Document Name
Document Type
Other-Attachment C-1 Screener (Engli
Other-Attachment C-2 Screener (Spani
Other-Attachment E-1 Focus Group Con
Other-Attachment E-2 Focus Group Con
Other-Attachment F-1 Focus Group Gui
Other-Attachment F-2 Focus Group Gui
Other-Attachment G-1 Focus Group Sti
Other-Attachment G-2 Focus Group Sti
Other-Attachment H-1 Focus Group Sti
Other-Attachment H-2 Focus Group Sti
Other-Attachment I-1 Focus Group Sti
Other-Attachment I-2 Focus Group Sti
Other-Attachment J-1 Focus Group Sti
Other-Attachment J-2 Focus Group Sti
Other-Attachment K-1 Focus Group Han
Other-Attachment K-2 Focus Group Han
Other-Attachment L-1 Focus Group Han
Other-Attachment L-2 Focus Group Han
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

SNAP-Eligible Qualitative Research (Individuals/Households 18-75 years) Respondents + non-respondents
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Attachment C-1 Screener (English)_062718.docx Attachment C-1 Screener (English)_062718.docx No   Paper Only
Other-Attachment C-2 Screener (Spanish)_062718.docx Attachment C-2 Screener (Spanish)_062718.docx No   Paper Only
Other-Attachment E-1 Focus Group Confirmation Form (English)_062718.docx Attachment E-1 Focus Group Confirmation Form (English)_062718.docx No   Paper Only
Other-Attachment E-2 Focus Group Confirmation Form (Spanish)_062718.docx Attachment E-2 Focus Group Confirmation Form (Spanish)_062718.docx No   Paper Only
Other-Attachment F-1 Focus Group Guide (English)_062718.docx Attachment F-1 Focus Group Guide (English)_062718.docx No   Paper Only
Other-Attachment F-2 Focus Group Guide (Spanish)_062718.docx Attachment F-2 Focus Group Guide (Spanish)_062718.docx No   Paper Only
Other-Attachment G-1 Focus Group Stimuli Email Newsletter (English)(1).pdf Attachment G-1 Focus Group Stimuli Email Newsletter (English) (1).pdf No   Paper Only
Other-Attachment G-2 Focus Group Stimuli Email Newsletter (Spanish)(1).pdf Attachment G-2 Focus Group Stimuli Email Newsletter (Spanish) (1).pdf No   Paper Only
Other-Attachment H-1 Focus Group Stimuli Social Media (English)(1).pdf Attachment H-1 Focus Group Stimuli Social Media (English) (1).pdf No   Paper Only
Other-Attachment H-2 Focus Group Stimuli Social Media (Spanish) (1).pdf Attachment H-2 Focus Group Stimuli Social Media (Spanish) (1).pdf No   Paper Only
Other-Attachment I-1 Focus Group Stimuli Apple and Peanut Butter Wrap Video (English).docx Attachment I-1 Focus Group Stimuli Apple and Peanut Butter Wrap Video (English).docx VIDEO TRANSCRIBED No   Paper Only
Other-Attachment I-2 Focus Group Stimuli Apple and Peanut Butter Wrap Video (Spanish).docx Attachment I-2 Focus Group Stimuli Apple and Peanut Butter Wrap Video (Spanish).docx VIDEO TRANSCRIBED No   Paper Only
Other-Attachment J-1 Focus Group Stimuli Frozen Fruit Cups Video (English).docx Attachment J-1 Focus Group Stimuli Frozen Fruit Cups Video (English).docx VIDEO TRANSCRIBED No   Paper Only
Other-Attachment J-2 Focus Group Stimuli Frozen Fruit Cups Video 8-1-18 (Spanish).docx Attachment J-2 Focus Group Stimuli Frozen Fruit Cups Video 8-1-18 (Spanish).docx VIDEO TRANSCRIBED No   Paper Only
Other-Attachment K-1 Focus Group Handout #1 (English)_062718.docx Attachment K-1 Focus Group Handout #1 (English)_062718.docx No   Paper Only
Other-Attachment K-2 Focus Group Handout #1 (Spanish)_062718.docx Attachment K-2 Focus Group Handout #1 (Spanish)_062718.docx No   Paper Only
Other-Attachment L-1 Focus Group Handout #2 (English)_062718.docx Attachment L-1 Focus Group Handout #2 (English)_062718.docx No   Paper Only
Other-Attachment L-2 Focus Group Handout #2 (Spanish).docx Attachment L-2 Focus Group Handout #2 (Spanish).docx No   Paper Only

Income Security Food and Nutrition Assistance

FNS-8 USDA/FNS Studies and Reports   65 FR 17251

840 0
   
Individuals or Households
 
   0 %

  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 840 0 840 0 0 0
Annual IC Time Burden (Hours) 497 0 497 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Generic OMB Memo Aug 21 2018 0584-0523 Generic Clearance Memo 8.21.18.docx 08/27/2018
Attachment A-1 Privacy Act Statement (English)_062718.docx Attachment A-1 Privacy Act Statement (English)_062718.docx 08/01/2018
Attachment A-2 Privacy Act Statement (Spanish)_062718.docx Attachment A-2 Privacy Act Statement (Spanish)_062718.docx 08/01/2018
Attachment B-1 Confidentiality Agreement_062718.docx Attachment B-1 Confidentiality Agreement_062718.docx 08/01/2018
Attachment D-1 Consent Form (English) Attachment D-1 Consent Form (English)_062718.docx 08/01/2018
Attachment D-2 Consent Form (Spanish)_062718.docx Attachment D-2 Consent Form (Spanish)_062718.docx 08/01/2018
Attachment M-1 Burden Hours Table_062718.xlsx Copy of Attachment M-1 Burden Hours Table_062718 (002).xlsx 08/27/2018
Attachment N Social Marketing and PSE Descriptions from SNAP Plan Guidance FY 8-1 2018.docx Attachment N Social Marketing and PSE Descriptions from SNAP Plan Guidance FY 2018.docx 08/27/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.