Information Collection

Cognitive Testing of Supplemental Nutrition Assistance Program Messaging for Able-Bodied Adults without Dependents

IC 259099 under ICR 202508-0607-002 · OMB 0607-0725.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0725 can be found here:

2025-12-30 - Revision of a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Cognitive Testing of Supplemental Nutrition Assistance Program Messaging for Able-Bodied Adults without Dependents	Form and Instruction
Form 1 Minnesota Protocol and Materials Cognitive Testing of Supplemental Nutrition Assistance Program Messaging for Able-Bodied Adults without Dependents	Form and Instruction
Form 2 Wisconsin Protocol and Materials Cognitive Testing of Supplemental Nutrition Assistance Program Messaging for Able-Bodied Adults without Dependents	Form and Instruction
1 Minnesota Protocol and Materials Enclosure 3 - Minnesota Protocol and Materials.docx	Form and Instruction
1 Minnesota Protocol and Materials Enclosure 3 - Minnesota Protocol and Materials.docx	Form and Instruction
2 Wisconsin Protocol and Materials Enclosure 4 - Wisconsin Protocol and Materials.docx	Form and Instruction
2 Wisconsin Protocol and Materials Enclosure 4 - Wisconsin Protocol and Materials.docx	Form and Instruction
OMB Memo - SNAP ABAWD Message Cognitive Testing in MN and WI.docx OMB Memo	IC Document
OMB Memo - SNAP ABAWD Message Cognitive Testing in MN and WI.docx OMB Memo	IC Document
Enclosure 1 - Recruitment Materials.docx Recruitment Materials	IC Document
Enclosure 1 - Recruitment Materials.docx Recruitment Materials	IC Document
Enclosure 2 - Additional Screening Questions.docx Additional Screening Questions	IC Document
Enclosure 2 - Additional Screening Questions.docx Additional Screening Questions	IC Document
Enclosure 5 - Consent Form.docx Consent Form	IC Document
Enclosure 5 - Consent Form.docx Consent Form	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Cognitive Testing of Supplemental Nutrition Assistance Program Messaging for Able-Bodied Adults without Dependents

Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

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
Form and Instruction	1				No		Fillable Fileable
Form and Instruction	2				No		Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 30

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	30	30
Annual IC Time Burden (Hours)	33	33
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OMB Memo		03/13/2023
Recruitment Materials		03/13/2023
Additional Screening Questions		03/13/2023
Consent Form		03/13/2023

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

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