Evaluation of FY 2019 Summer Electronic Benefit Transfer (EBT) Demonstrations - Parents/Caregivers of Children (2 of 3)

Generic Clearance to Conduct Formative Research or Development of Nutrition Education and Promotion Materials and Related Tools and Grants for FNS Population Groups

OMB: 0584-0524

IC ID: 242285

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0524 can be found here:

Documents and Forms

Document Name Document Type
Attachment F.1 Focus Group Sign-in Sheet.docx Other-Attachment F.1 Focus Group Sig
Attachment F.1 Focus Group Sign-in Sheet.docx Other-Attachment F.1 Focus Group Sig
Attachment F.2 Focus Group Consent Form.docx Other-Attachment F.2 Focus Group Con
Attachment F.2 Focus Group Consent Form.docx Other-Attachment F.2 Focus Group Con
Attachment F.3 ParentCaregiver Focus Group Interview Protocol_25 Jun 2020.docx Other-Attachment F.3 Parent/Caregive
Attachment F.3 ParentCaregiver Focus Group Interview Protocol_25 Jun 2020.docx Other-Attachment F.3 Parent/Caregive
Attachment F.4 Summer EBT_2022 Non-participant Interview Protocol _.docx Other-Attachment F.4 Summer EBT_2022
Attachment F.4 Summer EBT_2022 Non-participant Interview Protocol _.docx Other-Attachment F.4 Summer EBT_2022
Attachment A Burden table 6.17.20.xlsx Attachment A Burden Table IC Document
Attachment A Burden table 6.17.20.xlsx Attachment A Burden Table IC Document
Attachment J IRB Approval.pdf Attachment J IRB Approval IC Document
Attachment J IRB Approval.pdf Attachment J IRB Approval IC Document
Attachment G.1 Recruitment FlyerHandout for Focus Group_25 Jun 2020.docx Attachment G.1 Recruitment Flyer/Handout for Focus Group IC Document
Attachment G.1 Recruitment FlyerHandout for Focus Group_25 Jun 2020.docx Attachment G.1 Recruitment Flyer/Handout for Focus Group IC Document
Attachment G.2 Recruitment FAQ Sheet for Focus Groups_25 Jun 2020.docx Attachment G.2 Recruitment FAQ Sheet for Focus Groups IC Document
Attachment G.2 Recruitment FAQ Sheet for Focus Groups_25 Jun 2020.docx Attachment G.2 Recruitment FAQ Sheet for Focus Groups IC Document
Attachment G.3 Study Overview Sheet for Focus Group Participants_25 Jun ....docx Attachment G.3 Study Overview Sheet for Focus Group Participants IC Document
Attachment G.3 Study Overview Sheet for Focus Group Participants_25 Jun ....docx Attachment G.3 Study Overview Sheet for Focus Group Participants IC Document
Attachment G.4 Telephone Script for Focus Group Confirmation_25 Jun 2020.docx Attachment G.4 Telephone Script for Focus Group Confirmation IC Document
Attachment G.4 Telephone Script for Focus Group Confirmation_25 Jun 2020.docx Attachment G.4 Telephone Script for Focus Group Confirmation IC Document
Attachment G.5 Focus Group Confirmation Email Template for Focus Group_25 Jun 2020.docx Attachment G.5 Focus Group Confirmation Email Template for Focus Group Participants IC Document
Attachment G.5 Focus Group Confirmation Email Template for Focus Group_25 Jun 2020.docx Attachment G.5 Focus Group Confirmation Email Template for Focus Group Participants IC Document
2019 Summer EBT Generic Submission 25 Jun 2020 Memo.docx 2019 Summer EBT Generic Submission 25 Jun 2020 Memo IC Document
2019 Summer EBT Generic Submission 25 Jun 2020 Memo.docx 2019 Summer EBT Generic Submission 25 Jun 2020 Memo IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Evaluation of FY 2019 Summer Electronic Benefit Transfer (EBT) Demonstrations - Parents/Caregivers of Children (2 of 3)	Agency IC Tracking Number:

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-Attachment F.1 Focus Group Sign-In Sheet	Attachment F.1 Focus Group Sign-in Sheet.docx	No	Paper Only
Other-Attachment F.2 Focus Group Consent Form	Attachment F.2 Focus Group Consent Form.docx	No	Paper Only
Other-Attachment F.3 Parent/Caregiver Focus Group Interview Protocol	Attachment F.3 ParentCaregiver Focus Group Interview Protocol_25 Jun 2020.docx	No	Paper Only
Other-Attachment F.4 Summer EBT_2022 Non-participant Interview Protocol _	Attachment F.4 Summer EBT_2022 Non-participant Interview Protocol _.docx	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 FNS Studies and Reports	FR Citation: 56 FR 19078

Number of Respondents: 480	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	1,680	1,680
Annual IC Time Burden (Hours)	166	166
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment A Burden Table	Attachment A Burden table 6.17.20.xlsx	06/18/2020
Attachment J IRB Approval	Attachment J IRB Approval.pdf	06/18/2020
Attachment G.1 Recruitment Flyer/Handout for Focus Group	Attachment G.1 Recruitment FlyerHandout for Focus Group_25 Jun 2020.docx	06/26/2020
Attachment G.2 Recruitment FAQ Sheet for Focus Groups	Attachment G.2 Recruitment FAQ Sheet for Focus Groups_25 Jun 2020.docx	06/26/2020
Attachment G.3 Study Overview Sheet for Focus Group Participants	Attachment G.3 Study Overview Sheet for Focus Group Participants_25 Jun ....docx	06/26/2020
Attachment G.4 Telephone Script for Focus Group Confirmation	Attachment G.4 Telephone Script for Focus Group Confirmation_25 Jun 2020.docx	06/26/2020
Attachment G.5 Focus Group Confirmation Email Template for Focus Group Participants	Attachment G.5 Focus Group Confirmation Email Template for Focus Group_25 Jun 2020.docx	06/26/2020
2019 Summer EBT Generic Submission 25 Jun 2020 Memo	2019 Summer EBT Generic Submission 25 Jun 2020 Memo.docx	06/26/2020

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