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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.