OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

State, Local, and Tribal Governments Respondents

IC 268904 under ICR 202410-0584-004 · OMB 0584-0699.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Attachment D. SNAP State Agency Interview Protocol.docx Other-Attachment D. SNAP State Agenc
Attachment D. SNAP State Agency Interview Protocol.docx Other-Attachment D. SNAP State Agenc
Attachment E. SNAP Local Agency Interview Protocol.docx Other-Attachment E. SNAP Local Agenc
Attachment E. SNAP Local Agency Interview Protocol.docx Other-Attachment E. SNAP Local Agenc
Attachment F. SNAP E&T Provider Interview Protocol.docx Other-Attachment F. SNAP E&T Provide
Attachment F. SNAP E&T Provider Interview Protocol.docx Other-Attachment F. SNAP E&T Provide
Attachment G Interested Parties Interview Protocol .docx Other-Attachment G Interested Partie
Attachment G Interested Parties Interview Protocol .docx Other-Attachment G Interested Partie
Attachment H.1. Notification Email from FNS to States .docx Other-Attachment H.1. Notification E
Attachment H.1. Notification Email from FNS to States .docx Other-Attachment H.1. Notification E
Attachment H3 Email to SNAP State Directors .docx Other-Attachment H.3. Email to SNAP
Attachment H3 Email to SNAP State Directors .docx Other-Attachment H.3. Email to SNAP
Attachment H.5. Document Collection Guide.docx Other-Attachment H.5. Document Colle
Attachment H.5. Document Collection Guide.docx Other-Attachment H.5. Document Colle
Attachment H.13. Interview Scheduling Email 06142024.docx Other- Attachment H.13. Interview Sc
Attachment H.13. Interview Scheduling Email 06142024.docx Other- Attachment H.13. Interview Sc
Attachment H.14. Interview Consent Form 06142024.docx Other-Attachment H.14. Interview Con
Attachment H.14. Interview Consent Form 06142024.docx Other-Attachment H.14. Interview Con
Attachment C. Survey Instrument 10232024_final.docx Other-Attachment C. Survey Instrumen
Attachment C. Survey Instrument 10232024_final.docx Other-Attachment C. Survey Instrumen
Attachment H.2. Overall Project Summary.docx
Attachment H.2. Overall Project Summary		IC Document
Attachment H.2. Overall Project Summary.docx
Attachment H.2. Overall Project Summary		IC Document
Attachment H.6 Phone Scripts for Nonresponse Follow-Up.docx
Attachment H.6 Phone Scripts for Nonresponse Follow-Up		IC Document
Attachment H.6 Phone Scripts for Nonresponse Follow-Up.docx
Attachment H.6 Phone Scripts for Nonresponse Follow-Up		IC Document
Attachment H.7. Survey Reminder Email.docx
Attachment H.7. Survey Reminder Email		IC Document
Attachment H.7. Survey Reminder Email.docx
Attachment H.7. Survey Reminder Email		IC Document
Attachment H.8. Final Survey Reminder Email.docx
Attachment H.8. Final Survey Reminder Email		IC Document
Attachment H.8. Final Survey Reminder Email.docx
Attachment H.8. Final Survey Reminder Email		IC Document
Attachment H.9. Survey Thank-You Email.docx
Attachment H.9. Survey Thank-You Email		IC Document
Attachment H.9. Survey Thank-You Email.docx
Attachment H.9. Survey Thank-You Email		IC Document
Attachment H.10. Document Reminder Email_clean.docx
Attachment H.10. Document Reminder Email_clean		IC Document
Attachment H.10. Document Reminder Email_clean.docx
Attachment H.10. Document Reminder Email_clean		IC Document
Attachment H.11 Confirmation Email to Interview States.docx
Attachment H.11 Confirmation Email to Interview States		IC Document
Attachment H.11 Confirmation Email to Interview States.docx
Attachment H.11 Confirmation Email to Interview States		IC Document
Attachment H.12. Interview FAQ 06142024.docx
Attachment H.12. Interview FAQ		IC Document
Attachment H.12. Interview FAQ 06142024.docx
Attachment H.12. Interview FAQ		IC Document
Attachment H15 Key Informant Interview Thank You Email.docx
Attachment H.15. Key Informant Interview Thank You Email		IC Document
Attachment H15 Key Informant Interview Thank You Email.docx
Attachment H.15. Key Informant Interview Thank You Email		IC Document
Attachment H.4. Survey Frequently Asked Questions 10232024_final.docx
Attachment H.4. Survey Frequently Asked Questions 10232024_final		IC Document
Attachment H.4. Survey Frequently Asked Questions 10232024_final.docx
Attachment H.4. Survey Frequently Asked Questions 10232024_final		IC Document

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-Attachment D. SNAP State Agency Interview Protocol No   Paper Only
Other-Attachment E. SNAP Local Agency Interview Protocol No   Paper Only
Other-Attachment F. SNAP E&T Provider Interview Protocol No   Paper Only
Other-Attachment G Interested Parties Interview Protocol No   Paper Only
Other-Attachment H.1. Notification Email from FNS to States Yes No Printable Only
Other-Attachment H.3. Email to SNAP State Directors Launching Surveys Yes No Printable Only
Other-Attachment H.5. Document Collection Guide Yes Yes Fillable Fileable
Other- Attachment H.13. Interview Scheduling Email Yes No Printable Only
Other-Attachment H.14. Interview Consent Form Yes Yes Fillable Fileable
Other-Attachment C. Survey Instrument 10232024_final Yes Yes Fillable Fileable

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 1,111 0 0 0 0 1,111
Annual IC Time Burden (Hours) 308 0 0 0 0 308
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
Attachment H.2. Overall Project Summary 06/21/2024
Attachment H.6 Phone Scripts for Nonresponse Follow-Up 06/21/2024
Attachment H.7. Survey Reminder Email 06/21/2024
Attachment H.8. Final Survey Reminder Email 06/21/2024
Attachment H.9. Survey Thank-You Email 06/21/2024
Attachment H.10. Document Reminder Email_clean 06/21/2024
Attachment H.11 Confirmation Email to Interview States 06/21/2024
Attachment H.12. Interview FAQ 06/21/2024
Attachment H.15. Key Informant Interview Thank You Email 06/21/2024
Attachment H.4. Survey Frequently Asked Questions 10232024_final 10/23/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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