Information Collection

Individuals/Households (WIC Participants and Former WIC Participants)

IC 224850 under ICR 201611-0584-002 · OMB 0584-0627.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
G.2_Current Participant Survey English_FINAL.docx	Other-Appendix G.2 Survey of WIC Par
G.2a_Current Participant Survey Spanish_FINAL.docx	Other-Appendix G.2a Survey of WIC Pa
H.2_Former Participant Survey English_FINAL.docx	Other-Appendix H.2 Survey of Former
H.2a_Former Participant Survey Spanish_FINAL.docx	Other-Appendix H.2a Survey of Former
G.1_Participant Advance Letter English_FINAL.docx Appendix G.1 WIC Participant Advance Letter (English)	IC Document
G.1a_Participant Advance Letter Spanish.docx Appendix G.1a WIC Participant Advance Letter (Spanish)	IC Document
G.3_Reminder Postcard English Dec 2016.docx Appendix G.3 WIC Participant/Former Participant Reminder Postcard (English)	IC Document
G.3a_Reminder Postcard Spanish.docx Appendix G.3a WIC Participant/Former Participant Reminder Postcard (Spanish)	IC Document
G.4_Reminder Letter English Dec 2016.docx Appendix G.4 WIC Participant/Former Participant Reminder Letter (English)	IC Document
G.4a_Reminder Letter Spanish Dec 2016.docx Appendix G.4a WIC Participant/Former Participant Reminder Letter (Spanish)	IC Document
G.5_Refusal Letter English Dec 2016.docx Appendix G.5 WIC Participant/Former Participant Refusal Letter (English)	IC Document
G.5a_Refusal Letter Spanish Dec 2016.docx Appendix G.5a WIC Participant/Former Participant Refusal Letter (Spanish)	IC Document
H.1_Former Participant Advance Letter English.docx Appendix H.1 Former WIC Participant Advance Letter (English)	IC Document
H.1a_Former Participant Advance Letter Spanish.docx Appendix H.1a Former WIC Participant Advance Letter (Spanish)	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Individuals/Households (WIC Participants and Former WIC Participants)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Appendix G.2a Survey of WIC Participants (Spanish)	G.2a_Current Participant Survey Spanish_FINAL.docx	Yes	Yes	Fillable Fileable
Other-Appendix H.2 Survey of Former WIC Participants (English)	H.2_Former Participant Survey English_FINAL.docx	Yes	Yes	Fillable Fileable
Other-Appendix G.2 Survey of WIC Participants (English)	G.2_Current Participant Survey English_FINAL.docx	Yes	Yes	Fillable Fileable
Other-Appendix H.2a Survey of Former WIC Participants (Spanish)	H.2a_Former Participant Survey Spanish_FINAL.docx	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title: FNS-8 USDA FNS Studies and Reports

FR Citation: 56 FR 19078

Number of Respondents: 4,918

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 67 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	14,920	14,920
Annual IC Time Burden (Hours)	2,048	2,048
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix G.1 WIC Participant Advance Letter (English)	G.1_Participant Advance Letter English_FINAL.docx	09/25/2017
Appendix G.1a WIC Participant Advance Letter (Spanish)	G.1a_Participant Advance Letter Spanish.docx	09/25/2017
Appendix G.3 WIC Participant/Former Participant Reminder Postcard (English)	G.3_Reminder Postcard English Dec 2016.docx	12/19/2016
Appendix G.3a WIC Participant/Former Participant Reminder Postcard (Spanish)	G.3a_Reminder Postcard Spanish.docx	12/19/2016
Appendix G.4 WIC Participant/Former Participant Reminder Letter (English)	G.4_Reminder Letter English Dec 2016.docx	12/19/2016
Appendix G.4a WIC Participant/Former Participant Reminder Letter (Spanish)	G.4a_Reminder Letter Spanish Dec 2016.docx	12/19/2016
Appendix G.5 WIC Participant/Former Participant Refusal Letter (English)	G.5_Refusal Letter English Dec 2016.docx	12/19/2016
Appendix G.5a WIC Participant/Former Participant Refusal Letter (Spanish)	G.5a_Refusal Letter Spanish Dec 2016.docx	12/19/2016
Appendix H.1 Former WIC Participant Advance Letter (English)	H.1_Former Participant Advance Letter English.docx	12/19/2016
Appendix H.1a Former WIC Participant Advance Letter (Spanish)	H.1a_Former Participant Advance Letter Spanish.docx	12/19/2016

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