Information Collection

WIC Participants - Individuals and Households

IC 244259 under ICR 202010-0584-009 · OMB 0584-0663.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0663 can be found here:

2022-03-22 - Revision of a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
C7_Nutrition Services Observation Form.docx	Other-Appendix C7 Nutrition Services
C6_Nutrition Services Observation Form_remote_4.6.21 .docx	Other-Appendix C6 Nutrition Services
C9_WIC Participant Interview Guide.docx	Other-Appendix C9 WIC Participant In
C8_WIC Participant Interview Guide_remote_4.6.21.docx	Other-Appendix C8 WIC Participant In
C9a_WIC Participant Interview Guide-Spanish.docx	Other-Appendix C9a WIC Participant I
C8a_WIC Participant Interview Guide-Spanish_remote_4.6.21.docx	Other-Appendix C8a WIC Participant I
G8_WIC Participant Screener.docx	Other-Appendix G8 WIC Participant Sc
G8_WIC Participant Screener.docx	Other-Appendix G8 WIC Participant Sc
G8a_WIC Participant Screener-Spanish.docx	Other-Appendix G8a WIC Participant S
G8a_WIC Participant Screener-Spanish.docx	Other-Appendix G8a WIC Participant S
G9_Informed Consent for Observation and WIC Participant Interview.docx	Other-Appendix G9 Informed Consent f
G9_Informed Consent for Observation and WIC Participant Interview_remote_4.6.21.docx	Other-Appendix G9 Informed Consent f
G9a_Informed Consent for Observation and WIC Participant Interview-Spanish.docx	Other-Appendix G9a Informed Consent
G9a_Informed Consent for Observation and WIC Participant Interview-Spanish_remote.docx	Other-Appendix G9a Informed Consent
G7_Study Brochure for WIC Participant.pdf Appendix G7 Study Brochure for WIC Participant	IC Document
G7_Study Brochure for WIC Participant.pdf Appendix G7 Study Brochure for WIC Participant	IC Document
G7a_Study Brochure for WIC Participant-Spanish.pdf Appendix G7a Study Brochure for WIC Participant - Spanish	IC Document
G7a_Study Brochure for WIC Participant-Spanish.pdf Appendix G7a Study Brochure for WIC Participant - Spanish	IC Document
G10_Reminder Text for WIC Participant Interview to be Conducted Over the Phone.docx Appendix G10 Reminder Text for WIC Participant Interview to be Conducted Over the Phone	IC Document
G10_Reminder Text for WIC Participant Interview to be Conducted Over the Phone.docx Appendix G10 Reminder Text for WIC Participant Interview to be Conducted Over the Phone	IC Document
G10a_Reminder Text for WIC Participant Interview to be Conducted Over the Phone-Spanish.docx Appendix G10a Reminder Text for WIC Participant Interview to be Conducted Over the Phone - Spanish	IC Document
G10a_Reminder Text for WIC Participant Interview to be Conducted Over the Phone-Spanish.docx Appendix G10a Reminder Text for WIC Participant Interview to be Conducted Over the Phone - Spanish	IC Document
G11_Reminder Call for WIC Participant Interview to be Conducted Over the Phone.docx Appendix G11 Reminder Call for WIC Participant Interview to be Conducted Over the Phone	IC Document
G11_Reminder Call for WIC Participant Interview to be Conducted Over the Phone.docx Appendix G11 Reminder Call for WIC Participant Interview to be Conducted Over the Phone	IC Document
G11a_Reminder Call for WIC Participant Interview to be Conducted Over the Phone-Spanish.docx Appendix G11a Reminder Call for WIC Participant Interview to be Conducted Over the Phone - Spanish	IC Document
G11a_Reminder Call for WIC Participant Interview to be Conducted Over the Phone-Spanish.docx Appendix G11a Reminder Call for WIC Participant Interview to be Conducted Over the Phone - Spanish	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

WIC Participants - Individuals and Households

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 C6 Nutrition Services Observation Form	C6_Nutrition Services Observation Form_remote_4.6.21 .docx	No		Paper Only
Other-Appendix C8 WIC Participant Interview Guide	C8_WIC Participant Interview Guide_remote_4.6.21.docx	Yes	No	Paper Only
Other-Appendix C8a WIC Participant Interview Guide - Spanish	C8a_WIC Participant Interview Guide-Spanish_remote_4.6.21.docx	Yes	No	Paper Only
Other-Appendix G8 WIC Participant Screener	G8_WIC Participant Screener.docx	Yes	No	Paper Only
Other-Appendix G8a WIC Participant Screener - Spanish	G8a_WIC Participant Screener-Spanish.docx	Yes	No	Paper Only
Other-Appendix G9 Informed Consent for Observation and WIC Participant Interview	G9_Informed Consent for Observation and WIC Participant Interview_remote_4.6.21.docx	Yes	No	Paper Only
Other-Appendix G9a Informed Consent for Observation and WIC Participant Interview - Spanish	G9a_Informed Consent for Observation and WIC Participant Interview-Spanish_remote.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: 512

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	2,642	2,642
Annual IC Time Burden (Hours)	242	242
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix G7 Study Brochure for WIC Participant	G7_Study Brochure for WIC Participant.pdf	10/28/2020
Appendix G7a Study Brochure for WIC Participant - Spanish	G7a_Study Brochure for WIC Participant-Spanish.pdf	10/28/2020
Appendix G10 Reminder Text for WIC Participant Interview to be Conducted Over the Phone	G10_Reminder Text for WIC Participant Interview to be Conducted Over the Phone.docx	10/28/2020
Appendix G10a Reminder Text for WIC Participant Interview to be Conducted Over the Phone - Spanish	G10a_Reminder Text for WIC Participant Interview to be Conducted Over the Phone-Spanish.docx	10/28/2020
Appendix G11 Reminder Call for WIC Participant Interview to be Conducted Over the Phone	G11_Reminder Call for WIC Participant Interview to be Conducted Over the Phone.docx	10/28/2020
Appendix G11a Reminder Call for WIC Participant Interview to be Conducted Over the Phone - Spanish	G11a_Reminder Call for WIC Participant Interview to be Conducted Over the Phone-Spanish.docx	10/28/2020

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