Information Collection

WIC Outreach Campaign – Campaign Logo and Platform Concept Focus Groups

IC 267486 under ICR 202410-0584-002 · OMB 0584-0611.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0611 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment A-1 WIC Screener (English)_050724.docx	Other-Attachment A-1 WIC Screener -
Attachment A-2 WIC Eligible Screener (English) 050724.docx	Other-Attachment A-2 WIC Eligible Sc
Attachment A-3 WIC Screener (Spanish) 050724.docx	Other-Attachment A-3 WIC Screener -
Attachment A-4 WIC Eligible Screener (Spanish) 050724.docx	Other-Attachment A-4 WIC Eligibility
Attachment C-1 Consent Form (English) -1.docx	Other-Attachment C-1 Consent Form -
Attachment C-2 Consent Form (Spanish) -1.docx	Other-Attachment C-2 Consent Form -
Attachment D-1 WIC Platform Logo FG Guide (English) -1.docx	Other-Attachment D-1 WIC Focus Group
Attachment D-2 WIC Platform Logo FG Guide (Spanish)-1.docx	Other-Attachment D-2 WIC Platform Lo
Attachment F-1 2.1.1.3 WIC Program Logos for Testing.pptx	Other-F-1 Stimuli for Focus Groups
Attachment B-1 Confirmation Form (English) -1.docx	Other-B-1 Confirmation Form (English
Attachment B-2 Confirmation Form (Spanish) -1.docx	Other-B-2 Confirmation Form (Spanish
Attachment E-1 Determination Notice for Non Human Subjects Research (WIC - Logo and Platform Testing FGs).pdf E-1 IRB Determination Notice	IC Document
Fast Track Clearance WIC National Outreach Campaign Logo and Platform FGs_040524 -1.docx WIC Outreach Campaign – Campaign Logo and Platform Concept Focus Groups	IC Document

IC Title:

WIC Outreach Campaign â Campaign Logo and Platform Concept Focus Groups

Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Attachment A-1 WIC Screener - English	Yes	Yes	Fillable Printable
Other-Attachment A-2 WIC Eligible Screener - English	Yes	Yes	Fillable Printable
Other-Attachment A-3 WIC Screener - Spanish	Yes	Yes	Fillable Printable
Other-Attachment A-4 WIC Eligibility Screener - Spanish	Yes	Yes	Fillable Printable
Other-Attachment C-1 Consent Form - English	Yes	Yes	Fillable Printable
Other-Attachment C-2 Consent Form - Spanish	Yes	Yes	Fillable Printable
Other-Attachment D-1 WIC Focus Group Guide -English	Yes	Yes	Fillable Printable
Other-Attachment D-2 WIC Platform Logo FG Guide Spanish	Yes	Yes	Fillable Printable
Other-F-1 Stimuli for Focus Groups	Yes	Yes	Fillable Printable
Other-B-1 Confirmation Form (English)	Yes	Yes	Fillable Printable
Other-B-2 Confirmation Form (Spanish)	Yes	Yes	Fillable Printable

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 360

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	360	360
Annual IC Time Burden (Hours)	186	186
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
E-1 IRB Determination Notice		05/07/2024
WIC Outreach Campaign â Campaign Logo and Platform Concept Focus Groups		05/07/2024

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

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].