Information Collection

National Outreach Campaign Needs Assessment for WIC State and Local Agencies

IC 267826 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⚠️ Notice: This information collection may be referencing outdated material.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
CO3_5.2.1.2.7_WIC_SA_LA_Needs_Assessment_About_Final_5.8.24.docx	Other-WIC Needs Assessment
CO3_5.2.1.2.7_WIC_SA_LA_Needs_Assessment_Email_Invitation_Final_5.8.24.docx	Other-Needs Assessment Email Invitat
CO3_5.2.1.2.7_WIC_SA_LA_Needs_Assessment_Instrument_Final-5.8.24.docx	Other-Needs Assessment Instrument
CO3_5.2.1.2.7_WIC_SA_LA_Needs_Assessment_Screenshots_Final_5.8.24.docx	Other-Needs Assessment Screenshots
CO3_5.2.1.2.7_WIC_SA_LA_Needs_Assessment_Human_Subjects_Determination_Final_5.8.24.pdf Needs Assessment Human Subjects Determination	IC Document
WIC_SA_LA_Needs_Assessment_FAST_TRACK_CLEARANCE_FORM_Final_5.8.24.docx WIC_SA_LA Needs Assessment Fast Track Clearnce	IC Document

IC Title:

National Outreach Campaign Needs Assessment for WIC State and Local Agencies

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-WIC Needs Assessment	Yes	Yes	Fillable Printable
Other-Needs Assessment Email Invitation	Yes	Yes	Fillable Fileable
Other-Needs Assessment Instrument	Yes	Yes	Fillable Printable
Other-Needs Assessment Screenshots	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: 1,989

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	1,989	1,989
Annual IC Time Burden (Hours)	415	415
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Needs Assessment Human Subjects Determination		05/21/2024
WIC_SA_LA Needs Assessment Fast Track Clearnce		06/06/2024

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

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