Information Collection

Customer Opinion /Satisfaction Survey Regarding the WIC Integrity Profile (TIP Apllication)

IC 220874 under ICR 201611-0503-002 · OMB 0503-0021.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0503-0021 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
FNS WIC TIP Modernization Assessment_FINAL_Phase 1 - State Agency Survey.pdf	Other-Survey
FNS WIC TIP Clearance Submission_04212016 v3.doc Fast-Track Generic Template	IC Document

IC Title:

Customer Opinion /Satisfaction Survey Regarding the WIC Integrity Profile (TIP Apllication)

Agency IC Tracking Number:

0584

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

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-Survey			FNS WIC TIP Modernization Assessment_FINAL_Phase 1 - State Agency Survey.pdf		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 25

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
	Requested	Previously Approved
Annual Number of Responses for this IC	25	25
Annual IC Time Burden (Hours)	4	4
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fast-Track Generic Template	FNS WIC TIP Clearance Submission_04212016 v3.doc	04/21/2016

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