OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

State and Local Government Respondents

IC 263708 under ICR 202311-0584-006 · OMB 0584-0694.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Appendix B. State Administrator Interview Guide.docx Other-Appendix B. State Administrato
Appendix B. State Administrator Interview Guide.docx Other-Appendix B. State Administrato
Appendix C. Local Administrator Interview Guide.docx Other-Appendix C. Local Administrato
Appendix C. Local Administrator Interview Guide.docx Other-Appendix C. Local Administrato
Appendix D. State Information Technology Director or Manager Interview Guide.docx Other-Appendix D. State Information
Appendix D. State Information Technology Director or Manager Interview Guide.docx Other-Appendix D. State Information
Appendix E. Frontline Staff Interview Guide.docx Other-Appendix E. Frontline Staff In
Appendix E. Frontline Staff Interview Guide.docx Other-Appendix E. Frontline Staff In
Appendix G. Informed Consent Script.docx Other-Appendix G. Informed Consent S
Appendix G. Informed Consent Script.docx Other-Appendix G. Informed Consent S
Appendix I. Case Study Recruitment Email from FNS or CMS to SNAP or Medicaid Director_11.8 Updates.docx Other-Appendix I. Case Study Recruit
Appendix I. Case Study Recruitment Email from FNS or CMS to SNAP or Medicaid Director_11.8 Updates.docx Other-Appendix I. Case Study Recruit
Appendix J. Case Study Recruitment Email from Project Team to SNAP Director.docx Other-Appendix J. Case Study Recruit
Appendix J. Case Study Recruitment Email from Project Team to SNAP Director.docx Other-Appendix J. Case Study Recruit
Appendix K. Case Study Recruitment Email from Project Team to Medicaid Director.docx Other-Appendix K. Case Study Recruit
Appendix K. Case Study Recruitment Email from Project Team to Medicaid Director.docx Other-Appendix K. Case Study Recruit

Information Collection (IC) Details

View Information Collection (IC)

layout table

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 B. State Administrator Interview Guide Appendix B. State Administrator Interview Guide.docx No   Paper Only
Other-Appendix C. Local Administrator Interview Guide Appendix C. Local Administrator Interview Guide.docx No   Paper Only
Other-Appendix D. State Information Technology Director or Manager Interview Guide Appendix D. State Information Technology Director or Manager Interview Guide.docx No   Paper Only
Other-Appendix E. Frontline Staff Interview Guide Appendix E. Frontline Staff Interview Guide.docx No   Paper Only
Other-Appendix G. Informed Consent Script Appendix G. Informed Consent Script.docx No   Paper Only
Other-Appendix I. Case Study Recruitment Email from FNS or CMS to SNAP or Medicaid Director_11.8 Updates Appendix I. Case Study Recruitment Email from FNS or CMS to SNAP or Medicaid Director_11.8 Updates.docx Yes No Printable Only
Other-Appendix J. Case Study Recruitment Email from Project Team to SNAP Director Appendix J. Case Study Recruitment Email from Project Team to SNAP Director.docx Yes No Printable Only
Other-Appendix K. Case Study Recruitment Email from Project Team to Medicaid Director Appendix K. Case Study Recruitment Email from Project Team to Medicaid Director.docx Yes No Printable Only

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  Approved 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 230 0 230 0 0 0
Annual IC Time Burden (Hours) 123 0 123 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.