SNAP Recipient Focus Groups (I/H)

Nutrition Assistance in Farmers Markets: Understanding Shopping Patterns

Documents and Forms

Document Name Document Type
FM Appendix F2 FG Participant Consent Form 11-7-13.docx Other-Consent Form
FM Appendix F3 FG ParticipantDemographic survey 11-7-13.docx Other-Participant Demographic Survey
Appendix F4 FM Shopper protocol 11-7-11.docx Other-Moderator Script (FM shoppers)
FM Appendix F5 FG non shopper protocol 11-7-13.doc Other-Moderator script (non-FM shopp
Appendix F6 FG Participant Incentive Receipt Form 11-7-13.docx Other-Incentive Recipt
Appendix F4 FM Shopper protocol 11-7-11.docx Other-Appendix F4 FM Shopper protoco
Appendix F1 Focus Group Recruitmnet Script 11 18 11.docx Other-Appendix F1 Focus Group Recrui
Appendix F8 FG screened participant confirmation letter 11-10-11.docx Confirmation Letter IC Document
Appendix F7 Focus Group recruitment flyer 11.10.11.docx Appendix F7 Focus Group recruitment flyer IC Document

Information Collection (IC) Details

IC Title:	SNAP Recipient Focus Groups (I/H)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-Incentive Recipt	Appendix F6 FG Participant Incentive Receipt Form 11-7-13.docx	No	Paper Only
Other-Consent Form	FM Appendix F2 FG Participant Consent Form 11-7-13.docx	No	Paper Only
Other-Participant Demographic Survey	FM Appendix F3 FG ParticipantDemographic survey 11-7-13.docx	No	Paper Only
Other-Moderator Script (FM shoppers)	Appendix F4 FM Shopper protocol 11-7-11.docx	No	Printable Only
Other-Moderator script (non-FM shoppers)	FM Appendix F5 FG non shopper protocol 11-7-13.doc	No	Printable Only
Other-Appendix F4 FM Shopper protocol 11/17/2011	Appendix F4 FM Shopper protocol 11-7-11.docx	No	Paper Only
Other-Appendix F1 Focus Group Recruitment Script	Appendix F1 Focus Group Recruitmnet Script 11 18 11.docx	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: 65 FR 17251

Number of Respondents: 32	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	32	32
Annual IC Time Burden (Hours)	488	488
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Confirmation Letter	Appendix F8 FG screened participant confirmation letter 11-10-11.docx	11/18/2011
Appendix F7 Focus Group recruitment flyer	Appendix F7 Focus Group recruitment flyer 11.10.11.docx	11/18/2011

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