Information Collection

Individuals/Households

IC 246111 under ICR 202211-0584-010 · OMB 0584-0671.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix E Individuals-Households in-depth interview guide_6_24_2021_passback (10-12-21)_revised_clean 10.30.21.docx	Other-Appendix E Individuals-Househo
Appendix E Individuals-Households in-depth interview guide_6_24_2021_passback (10-12-21)_revised_clean 10.30.21.docx	Other-Appendix E Individuals-Househo
Appendix M Consent form for SNAP client in-depth interviews_6_24_2021.docx Appendix M Consent form for individuals-households in-depth interviews	IC Document
Appendix M Consent form for SNAP client in-depth interviews_6_24_2021.docx Appendix M Consent form for individuals-households in-depth interviews	IC Document
F1_Invitation call script_revised Clean_11.3.22.docx F1_Invitation call script_revised Clean_11.3.22	IC Document
F1_Invitation call script_revised Clean_11.3.22.docx F1_Invitation call script_revised Clean_11.3.22	IC Document
F2_Confirmation letter revised Clean_11.3.22.docx F2_Confirmation letter revised Clean_11.3.22	IC Document
F2_Confirmation letter revised Clean_11.3.22.docx F2_Confirmation letter revised Clean_11.3.22	IC Document
F3 Reminder script_revised Clean_11.3.22.docx F3 Reminder script_revised Clean_11.3.22	IC Document
F3 Reminder script_revised Clean_11.3.22.docx F3 Reminder script_revised Clean_11.3.22	IC Document

IC Title:

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	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Appendix E Individuals-Households in-depth interview guide			Appendix E Individuals-Households in-depth interview guide_6_24_2021_passback (10-12-21)_revised_clean 10.30.21.docx		No		Paper Only

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title: USDA/FNS 8 FNS Studies and Reports

FR Citation: 56 FR 19078

Number of Respondents: 300

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	Previously Approved
Annual Number of Responses for this IC	1,500	1,500
Annual IC Time Burden (Hours)	474	474
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix M Consent form for individuals-households in-depth interviews	Appendix M Consent form for SNAP client in-depth interviews_6_24_2021.docx	07/26/2021
F1_Invitation call script_revised Clean_11.3.22	F1_Invitation call script_revised Clean_11.3.22.docx	11/16/2022
F2_Confirmation letter revised Clean_11.3.22	F2_Confirmation letter revised Clean_11.3.22.docx	11/16/2022
F3 Reminder script_revised Clean_11.3.22	F3 Reminder script_revised Clean_11.3.22.docx	11/16/2022

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