Information Collection

Caregivers of Former WIC Children (Individuals/Households)

IC 203577 under ICR 201810-0584-001 · OMB 0584-0580.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0580 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
App_A1.Study extension consent age 6 - English 8.23.18.docx	Other-Appendix A1 Study Extension Co
App_A2.Study extension consent age 6 - Spanish 8.23.18.docx	Other-Appendix A2 Study Extension Co
App_B1.Study extension letter - English 8.23.18.docx	Other-Appendix B1 Study Extension Le
App_B2.Study extension letter - Spanish 8.23.18.docx	Other-Appendix B2 Study Extension Le
App_C1.72-month advance letter - English 8.24.18.docx	Other-Appendix C1 72-month Advance L
App_C2.72-month advance letter - Spanish 8.24.18.docx	Other-Appendix C2 72-month Advance L
App_D1.72-month telephone interview - English 10-8-18.docx	Other-Appendix D1 72-month Telephone
App_D2.72-month telephone interview - Spanish 10-8-18.docx	Other-Appendix D2 72-month Telephone
App_D3.72-month replicate dietary intake interview - English 10-8-18.docx	Other-Appendix D3 72-month Replicate
App_D4.72-month replicate dietary intake interview - Spanish 10-8-18.docx	Other-Appendix D4 72-month Replicate
App_F1.72-month HW measurement card - English 10-8-18.docx	Other-Appendix F1 72-month H/W Measu
App_F2.72-month HW measurement card - Spanish 10-8-18.docx	Other-Appendix F2 72-month H/W Measu
App_H1.72-month text or email provider measures - English 8.24.18.docx	Other-Appendix H1 72-month Text or E
App_H2.72-month text or email provider measures - Spanish 8.24.18.docx	Other-Appendix H2 72-month Text or E
App_E1a.Reminders for interview from Study Liaison - English 10.1.18.docx Appendix E1a Reminders for Interview from Study Liaison - English	IC Document
App_E1b.Reminders for interview from Study Liaison - Spanish 10.1.18.docx Appendix E1b Reminders for Interview from Study Liaison - Spanish	IC Document
App_E2a.Reminders for non-locatable active interview - English 10.1.18.docx Appendix E2a Reminders for Non-Locatable Active Interview - English	IC Document
App_E2b.Reminders for non-locatable active interview - Spanish 10.1.18.docx Appendix E2b Reminders for Non-Locatable Active Interview - Spanish	IC Document
App_E3a.Reminders for study participation refusal conversion - English 10.1.18.docx Appendix E3a Reminders for Study Participation Refusal Conversion - English	IC Document
App_E3b.Reminders for study participation refusal conversion - Spanish 10.1.18.docx Appendix E3b Reminders for Study Participation Refusal Conversion - Spanish	IC Document
App_E4a.Reminders for study participation not answering calls - English 10.1.18.docx Appendix E4a Reminders for Study Participation Not Answering Calls - English	IC Document
App_E4b.Reminders for study participation not answering calls - Spanish 10.118.docx Appendix E4b Reminders for Study Participation Not Answering Calls - Spanish	IC Document
App_E5a.Reminders for Telephone Research Center voicemail , first message - English 10.1.18.docx Appendix E5a Reminders for Telephone Research Center Voicemail, First Message - English	IC Document
App_E5b Reminders for Telephone Research Center voicemail , first message - Spanish 10.1.18.docx Appendix E5b Reminders for Telephone Research Center Voicemail, First Message - Spanish	IC Document
App_E6a.Reminders for Telephone Research Center voicemail, expiring interview - English 10.1.18.docx Appendix E6a Reminders for Telephone Research Center Voicemail, Expiring Interviews - English	IC Document
App_E6b.Reminders for Telephone Research Center voicemail, expiring interview - Spanish 10.1.18.docx Appendix E6b Reminders for Telephone Research Center Voicemail, Expiring Interviews - Spanish	IC Document
App_G1.Height and weight reminders - English 10.1.18.docx Appendix G1 Height and Weight Reminders - English	IC Document
App_G2.Height and weight reminders - Spanish 10.1.18.docx Appendix G2 Height and Weight Reminders - Spanish	IC Document
App_I1.72-month thank you - English 10.1.8.docx Appendix I1 72-month Thank You - English	IC Document
App_I2.72-month thank you - Spanish 10.1.18.docx Appendix I2 72-month Thank You - Spanish	IC Document
App_J1.Birthday card respondent year 6 - English 10.1.18.docx Appendix J1 Birthday Card Respondent Year 6 - English	IC Document
App_J2.Birthday card respondent year 6 - Spanish 10.1.18.docx Appendix J2 Birthday Card Respondent Year 6 - Spanish	IC Document
App_K1.Birthday card child age 6 - English 10.1.18.docx Appendix K1 Birthday Card Child Age 6 - English	IC Document
App_K2.Birthday card child age 6 - Spanish10.1.18.docx Appendix K2 Birthday Card Child Age 6 - Spanish	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Caregivers of Former WIC Children (Individuals/Households)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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 C2 72-month Advance Letter - Spanish	App_C2.72-month advance letter - Spanish 8.24.18.docx	No		Paper Only
Other-Appendix D1 72-month Telephone Interview - English	App_D1.72-month telephone interview - English 10-8-18.docx	Yes	Yes	Fillable Fileable
Other-Appendix D2 72-month Telephone Interview - Spanish	App_D2.72-month telephone interview - Spanish 10-8-18.docx	Yes	Yes	Fillable Fileable
Other-Appendix D3 72-month Replicate Dietary Intake Interview - English	App_D3.72-month replicate dietary intake interview - English 10-8-18.docx	Yes	Yes	Fillable Fileable
Other-Appendix D4 72-month Replicate Dietary Intake Interview - Spanish	App_D4.72-month replicate dietary intake interview - Spanish 10-8-18.docx	Yes	Yes	Fillable Fileable
Other-Appendix A1 Study Extension Consent Age 6 - English	App_A1.Study extension consent age 6 - English 8.23.18.docx	No		Paper Only
Other-Appendix A2 Study Extension Consent Age 6 - Spanish	App_A2.Study extension consent age 6 - Spanish 8.23.18.docx	No		Paper Only
Other-Appendix B1 Study Extension Letter - English	App_B1.Study extension letter - English 8.23.18.docx	No		Paper Only
Other-Appendix B2 Study Extension Letter - Spanish	App_B2.Study extension letter - Spanish 8.23.18.docx	No		Paper Only
Other-Appendix C1 72-month Advance Letter - English	App_C1.72-month advance letter - English 8.24.18.docx	No		Paper Only
Other-Appendix F1 72-month H/W Measurement Card - English	App_F1.72-month HW measurement card - English 10-8-18.docx	No		Paper Only
Other-Appendix F2 72-month H/W Measurement Card - Spanish	App_F2.72-month HW measurement card - Spanish 10-8-18.docx	No		Paper Only
Other-Appendix H1 72-month Text or Email Provider Measures - English	App_H1.72-month text or email provider measures - English 8.24.18.docx	Yes	No	Paper Only
Other-Appendix H2 72-month Text or Email Provider Measures - Spanish	App_H2.72-month text or email provider measures - Spanish 8.24.18.docx	Yes	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: FNS-8 USDA/FNS Studies and Reports

FR Citation: 56 FR 19078

Number of Respondents: 2,969

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 70 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	27,009	-74,010	101,019
Annual IC Time Burden (Hours)	3,831	-5,876	9,707
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix E1a Reminders for Interview from Study Liaison - English	App_E1a.Reminders for interview from Study Liaison - English 10.1.18.docx	10/11/2018
Appendix E1b Reminders for Interview from Study Liaison - Spanish	App_E1b.Reminders for interview from Study Liaison - Spanish 10.1.18.docx	10/11/2018
Appendix E2a Reminders for Non-Locatable Active Interview - English	App_E2a.Reminders for non-locatable active interview - English 10.1.18.docx	10/11/2018
Appendix E2b Reminders for Non-Locatable Active Interview - Spanish	App_E2b.Reminders for non-locatable active interview - Spanish 10.1.18.docx	10/11/2018
Appendix E3a Reminders for Study Participation Refusal Conversion - English	App_E3a.Reminders for study participation refusal conversion - English 10.1.18.docx	10/11/2018
Appendix E3b Reminders for Study Participation Refusal Conversion - Spanish	App_E3b.Reminders for study participation refusal conversion - Spanish 10.1.18.docx	10/11/2018
Appendix E4a Reminders for Study Participation Not Answering Calls - English	App_E4a.Reminders for study participation not answering calls - English 10.1.18.docx	10/11/2018
Appendix E4b Reminders for Study Participation Not Answering Calls - Spanish	App_E4b.Reminders for study participation not answering calls - Spanish 10.118.docx	10/11/2018
Appendix E5a Reminders for Telephone Research Center Voicemail, First Message - English	App_E5a.Reminders for Telephone Research Center voicemail , first message - English 10.1.18.docx	10/11/2018
Appendix E5b Reminders for Telephone Research Center Voicemail, First Message - Spanish	App_E5b Reminders for Telephone Research Center voicemail , first message - Spanish 10.1.18.docx	10/11/2018
Appendix E6a Reminders for Telephone Research Center Voicemail, Expiring Interviews - English	App_E6a.Reminders for Telephone Research Center voicemail, expiring interview - English 10.1.18.docx	10/11/2018
Appendix E6b Reminders for Telephone Research Center Voicemail, Expiring Interviews - Spanish	App_E6b.Reminders for Telephone Research Center voicemail, expiring interview - Spanish 10.1.18.docx	10/11/2018
Appendix G1 Height and Weight Reminders - English	App_G1.Height and weight reminders - English 10.1.18.docx	10/11/2018
Appendix G2 Height and Weight Reminders - Spanish	App_G2.Height and weight reminders - Spanish 10.1.18.docx	10/11/2018
Appendix I1 72-month Thank You - English	App_I1.72-month thank you - English 10.1.8.docx	10/12/2018
Appendix I2 72-month Thank You - Spanish	App_I2.72-month thank you - Spanish 10.1.18.docx	10/12/2018
Appendix J1 Birthday Card Respondent Year 6 - English	App_J1.Birthday card respondent year 6 - English 10.1.18.docx	10/12/2018
Appendix J2 Birthday Card Respondent Year 6 - Spanish	App_J2.Birthday card respondent year 6 - Spanish 10.1.18.docx	10/12/2018
Appendix K1 Birthday Card Child Age 6 - English	App_K1.Birthday card child age 6 - English 10.1.18.docx	10/12/2018
Appendix K2 Birthday Card Child Age 6 - Spanish	App_K2.Birthday card child age 6 - Spanish10.1.18.docx	10/12/2018

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