Information Collection

Individuals/Households SNAP Participants Respondents

IC 238962 under ICR 201912-0584-002 · OMB 0584-0659.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0659 can be found here:

Documents and Forms

Document Name Document Type
K. SNAP Participants Focus Group Protocol_final_clean_final response to PRAO.docx Other-K. SNAP Participants Focus Gro
L. SNAP Office Waiting Room Questionnaire_final_clean_final response to PRAO.docx Other-L. SNAP Office Waiting Room Qu
N. SNAP Participants Focus Group Eligibility Screener_final_clean_final response to PRAO.docx Other-N. SNAP Participants Focus Gro
O. SNAP Participants Focus Group Demographic Questionnaire_final_clean_final response to PRAO.docx Other-O. SNAP Participants Focus Gro
P. Consent Form for Waiting Room Questionnaire Participants_final_clean_final response to PRAO.docx P. Consent Form for Waiting Room Questionnaire Participants_final_clean_final response to PRAO.docx IC Document
Q. Consent Form for Focus Group With SNAP Participants_final_clean_final response to PRAO.docx Q. Consent Form for Focus Group With SNAP Participants_final_clean_final response to PRAO.docx IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Individuals/Households SNAP Participants Respondents	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-K. SNAP Participants Focus Group Protocol_final_clean_final response to PRAO.docx	K. SNAP Participants Focus Group Protocol_final_clean_final response to PRAO.docx	No	Paper Only
Other-L. SNAP Office Waiting Room Questionnaire_final_clean_final response to PRAO.docx	L. SNAP Office Waiting Room Questionnaire_final_clean_final response to PRAO.docx	No	Paper Only
Other-N. SNAP Participants Focus Group Eligibility Screener_final_clean_final response to PRAO.docx	N. SNAP Participants Focus Group Eligibility Screener_final_clean_final response to PRAO.docx	No	Paper Only
Other-O. SNAP Participants Focus Group Demographic Questionnaire_final_clean_final response to PRAO.docx	O. SNAP Participants Focus Group Demographic Questionnaire_final_clean_final response to PRAO.docx	No	Paper Only

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title: USDA/FNS 10 Persons Doing Business with FNS	FR Citation: 65 FR 17251

Number of Respondents: 245	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	651	651
Annual IC Time Burden (Hours)	179	179
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
P. Consent Form for Waiting Room Questionnaire Participants_final_clean_final response to PRAO.docx	P. Consent Form for Waiting Room Questionnaire Participants_final_clean_final response to PRAO.docx	03/06/2020
Q. Consent Form for Focus Group With SNAP Participants_final_clean_final response to PRAO.docx	Q. Consent Form for Focus Group With SNAP Participants_final_clean_final response to PRAO.docx	03/06/2020

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