Information Collection

Individuals and Households

IC 258097 under ICR 202501-0584-001 · OMB 0584-0682.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
D. Study Brochure (English-Spanish).pdf	Other-D. Study Brochure (English-Spa
E1. Endorsement Letter (English).docx	Other-E1. Endorsement Letter (Englis
E2. Endorsement Letter (Spanish).docx	Other-E2. Endorsement Letter (Spanis
H. Survey Door Hanger (English-Spanish).pdf	Other-H. Survey Door Hanger (English
J1. Survey Refusal Letter (English).docx	Other-J1. Survey Refusal Letter (Eng
J2. Survey Refusal Letter (Spanish).docx	Other- J2. Survey Refusal Letter (Sp
O1. IDI Consent Form (English).docx	Other-O1. IDI Consent Form (English)
O2. IDI Consent Form (Spanish).docx	Other-O2. IDI Consent Form (Spanish)
P1. IDI Interview Guide (English).docx	Other-P1. IDI Interview Guide (Engli
P2. IDI Interview Guide (Spanish).docx	Other-P2. IDI Interview Guide (Spani
C1. Survey Invitation (English).docx	Other-C1. Survey Invitation (English
C2. Survey Invitation (Spanish).docx	Other-C2. Survey Invitation (Spanish
L1. IDI Invitation Call Script (English).docx	Other-L1. IDI Invitation Call Script
L2. IDI Invitation Call Script (Spanish).docx	Other-L2. IDI Invitation Call Script
M1. IDI Confirmation Letter-Email (English).docx	Other-M1. IDI Confirmation Letter-Em
M2. IDI Confirmation Letter-Email (Spanish).docx	Other-M2. IDI Confirmation Letter-Em
S2. Screenshots of Web Survey (English).docx	Other-S2. Screenshots of Web Survey
S3. Screenshots of Web Survey (Spanish).docx	Other-S3. Screenshots of Web Survey
S1. Household Survey (English-Spanish).docx	Other-S1. Household Survey (English-
Appendix Z. IDI recruitment text message Jan 2.docx	Other-Appendix Z. IDI recruitment te
F1. First Survey Reminder Letter (English).docx F1. First Survey Reminder Letter (English)	IC Document
F2. First Survey Reminder Letter (Spanish).docx F2. First Survey Reminder Letter (Spanish)	IC Document
G1. Second Survey Reminder Letter (English).docx G1. Second Survey Reminder Letter (English)	IC Document
G2. Second Survey Reminder Letter (Spanish).docx G2. Second Survey Reminder Letter (Spanish)	IC Document
K1. Thank You Letter (English).docx K1. Thank You Letter (English)	IC Document
K2. Thank You Letter (Spanish).docx K2. Thank You Letter (Spanish)	IC Document
N1. IDI Reminder Call Script (English).docx N1. IDI Reminder Call Script (English)	IC Document
N2. IDI Reminder Call Script (Spanish).docx N2. IDI Reminder Call Script (Spanish)	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Individuals and Households

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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-D. Study Brochure (English-Spanish)	Yes	No	Printable Only
Other-E1. Endorsement Letter (English)	No		Paper Only
Other-E2. Endorsement Letter (Spanish)	No		Paper Only
Other-H. Survey Door Hanger (English-Spanish)	No		Paper Only
Other-J1. Survey Refusal Letter (English)	No		Paper Only
Other- J2. Survey Refusal Letter (Spanish)	No		Paper Only
Other-O1. IDI Consent Form (English)	Yes	No	Printable Only
Other-O2. IDI Consent Form (Spanish)	Yes	No	Printable Only
Other-P1. IDI Interview Guide (English)	No		Paper Only
Other-P2. IDI Interview Guide (Spanish)	No		Paper Only
Other-C1. Survey Invitation (English)	Yes	Yes	Printable Only
Other-C2. Survey Invitation (Spanish)	Yes	Yes	Printable Only
Other-L1. IDI Invitation Call Script (English)	No		Paper Only
Other-L2. IDI Invitation Call Script (Spanish)	No		Paper Only
Other-M1. IDI Confirmation Letter-Email (English)	Yes	No	Printable Only
Other-M2. IDI Confirmation Letter-Email (Spanish)	Yes	No	Printable Only
Other-S2. Screenshots of Web Survey (English)	Yes	Yes	Fillable Printable
Other-S3. Screenshots of Web Survey (Spanish)	Yes	Yes	Fillable Printable
Other-S1. Household Survey (English-Spanish)	Yes	Yes	Fillable Fileable
Other-Appendix Z. IDI recruitment text message Jan 2	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title: FNS-8 USDA/FNS Studies and Reports

FR Citation: 56 FR 19078

Number of Respondents: 16,121

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	87,029	563	86,466
Annual IC Time Burden (Hours)	6,675	9	6,666
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
F1. First Survey Reminder Letter (English)		01/27/2023
F2. First Survey Reminder Letter (Spanish)		01/27/2023
G1. Second Survey Reminder Letter (English)		01/27/2023
G2. Second Survey Reminder Letter (Spanish)		01/27/2023
K1. Thank You Letter (English)		01/27/2023
K2. Thank You Letter (Spanish)		01/27/2023
N1. IDI Reminder Call Script (English)		04/14/2023
N2. IDI Reminder Call Script (Spanish)		04/14/2023

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

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