Information Collection

State, Local, and Tribal Government

IC 279437 under ICR 202603-0584-001 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
B-1. Case study agency WIC director interview guide1-6.docx	Other-B-1. Case study agency WIC dir
B-2. Geo State WIC director interview guide.docx	Other-B-2. Geo State WIC director in
B-3. Clinic staff interview guide.docx	Other-B-3. Clinic staff interview gu
B-5. WIC appointment observation guide.docx	Other-B-5. WIC appointment observati
B-6. Interview guide pretest protocol.docx	Other-B-6. Interview guide pretest p
C-1. Case study agency virtual recruitment.docx	Other-C-1. Case study agency virtual
C-2. Geo State agency virtual recruitment.docx	Other-C-2. Geo State agency virtual
C-6. Site visit recruitment communications.docx	Other-C-6. Site visit recruitment co
C-7. Site visit planning meeting talking points.docx	Other-C-7. Site visit planning meeti
C-8. Clinic visit recruitment communication.docx	Other-C-8. Clinic visit recruitment
C-9. Clinic visit planning talking points.docx	Other-C-9. Clinic visit planning tal
C-11. WIC participant study FAQ.docx	Other-C-11. WIC participant study FA
C-3. Study FAQ (2).docx	Other-C-3. Study FAQ
C-10. Site visit informed consent form (2).docx	Other-C-10. Site visit informed cons
B-4. WIC clinic observation guide.docx B-4. WIC clinic observation guide	IC Document
C-5. Virtual interview thank you email.docx C-5. Virtual interview thank you email	IC Document
C-12. Site visit thank you email.docx C-12. Site visit thank you email	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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-B-1. Case study agency WIC director interview guide1-6	No		Paper Only
Other-B-2. Geo State WIC director interview guide	No		Paper Only
Other-B-3. Clinic staff interview guide	No		Paper Only
Other-B-5. WIC appointment observation guide	No		Paper Only
Other-B-6. Interview guide pretest protocol	No		Paper Only
Other-C-1. Case study agency virtual recruitment	Yes	Yes	Printable Only
Other-C-2. Geo State agency virtual recruitment	Yes	Yes	Printable Only
Other-C-6. Site visit recruitment communications	Yes	Yes	Printable Only
Other-C-7. Site visit planning meeting talking points	No		Paper Only
Other-C-8. Clinic visit recruitment communication	Yes	Yes	Printable Only
Other-C-9. Clinic visit planning talking points	No		Paper Only
Other-C-11. WIC participant study FAQ	No		Paper Only
Other-C-3. Study FAQ	No		Paper Only
Other-C-10. Site visit informed consent form	No		Paper Only

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: 140

Number of Respondents for Small Entity: 25

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	488	488
Annual IC Time Burden (Hours)	263	263
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
B-4. WIC clinic observation guide		03/12/2026
C-5. Virtual interview thank you email		03/12/2026
C-12. Site visit thank you email		03/12/2026

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].