WIC National Outreach Campaign Formative Focus Groups

FNS Fast Track Clearance for the Collection of Routine Customer Feedback

OMB: 0584-0611

IC ID: 259313

Documents and Forms
Document Name
Document Type
Other-Attachment A-1 WIC Par Screene
Other-Attachment A-2 WIC Non-Par Scr
Other-Attachment A-3 WIC Par Screene
Other-Attachment A-4 WIC Non-Par Scr
Other-Attachment B-1 Confirmation Fo
Other-Attachment B-2 Confirmation Fo
Other-Attachment C-1 Consent Form (E
Other-Attachment C-2 Consent Form (S
Other-Attachment D-1 WIC FG Guide Pa
Other-Attachment D-2 WIC FG Guide No
Other-Attachment D-3 WIC FG Guide Pa
Other-Attachment D-4 WIC FG Guide No
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

WIC National Outreach Campaign Formative Focus Groups
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Attachment A-1 WIC Par Screener (English) UPDATED Attachment A-1 WIC Par Screener (English) UPDATED.docx Yes No Fillable Printable
Other-Attachment A-2 WIC Non-Par Screener (English) UPDATED Attachment A-2 WIC Non-Par Screener (English) UPDATED.docx Yes No Fillable Printable
Other-Attachment A-3 WIC Par Screener (Spanish) UPDATED Attachment A-3 WIC Par Screener (Spanish) UPDATED.docx Yes No Fillable Printable
Other-Attachment A-4 WIC Non-Par Screener (Spanish) UPDATED Attachment A-4 WIC Non-Par Screener (Spanish) UPDATED.docx Yes No Fillable Printable
Other-Attachment B-1 Confirmation Form (English) UPDATED Attachment B-1 Confirmation Form (English) UPDATED.docx No   Paper Only
Other-Attachment B-2 Confirmation Form (Spanish) UPDATED Attachment B-2 Confirmation Form (Spanish) UPDATED.docx No   Paper Only
Other-Attachment C-1 Consent Form (English) UPDATED Attachment C-1 Consent Form (English) UPDATED.docx No   Paper Only
Other-Attachment C-2 Consent Form (Spanish) UPDATED Attachment C-2 Consent Form (Spanish) UPDATED.docx No   Paper Only
Other-Attachment D-1 WIC FG Guide Participants (English) UPDATED Attachment D-1 WIC FG Guide Participants (English) UPDATED.docx No   Paper Only
Other-Attachment D-2 WIC FG Guide NonParticipants (English) UPDATED Attachment D-2 WIC FG Guide NonParticipants (English) UPDATED.docx No   Paper Only
Other-Attachment D-3 WIC FG Guide Participants (Spanish) UPDATED Attachment D-3 WIC FG Guide Participants (Spanish) UPDATED.docx No   Paper Only
Other-Attachment D-4 WIC FG Guide NonParticipants (Spanish) UPDATED Attachment D-4 WIC FG Guide NonParticipants (Spanish) UPDATED.docx No   Paper Only

Income Security Food and Nutrition Assistance

 

800 0
   
Individuals or Households
 
   0 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 3,200 0 0 0 0 3,200
Annual IC Time Burden (Hours) 414 0 0 0 0 414
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Fast Track Clearance WIC National Outreach Campaign Formative FGs UPDATED_4_4_23 Fast Track Clearance WIC National Outreach Campaign Formative FGs UPDATED_4_4_23 .docx 04/05/2023
Attachment E-1 Determination Notice for Non Human Subjects Research Attachment E-1 Determination Notice for Non Human Subjects Research.pdf 04/05/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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