WIC Participants

Evaluation of the Birth Month Breastfeeding Changes to the WIC Food Packages Study

Documents and Forms

Document Name Document Type
WIC Participant Survey_10.16.08.doc Other-Questionnaire
Brochure WIC Participant_10.16.08.doc Brochure for Participants IC Document
Letter from LWAs to Selected Participants.10.16.08.doc Letter to Participants from LWA IC Document
LW_ Letter from LWAs to Selected Participants 10 16 08_spa_final.doc Spanish Letter to Participants from LWA IC Document
LW_Brochure WIC Participant_10 16 08_spa_final.doc Brochure for Participants (Spanish) IC Document
LW_Participant_consent.10.16.08_spa_final.doc Participant Consent Form (Spanish) IC Document
Participant_consent.10.16.08.doc Participant Consent Form IC Document
LW_Participant_consent.10.16.08_spa_final.doc Participant Consent Form (Spanish) IC Document
Recruit LWA letter.10.16.08.doc Recruitment Letter to Sampled LWA IC Document
Abt follow-up letter to State Agencies.10.16.08.doc Abt follow-up letter to State Agencies IC Document

Information Collection (IC) Details

IC Title:	WIC Participants	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 7 CFR 247.19

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Questionnaire			WIC Participant Survey_10.16.08.doc		No		Paper Only

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title: FNS Studies and Reports	FR Citation: 56 FR 19078

Number of Respondents: 1,280	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,280	1,280
Annual IC Time Burden (Hours)	640	640
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Brochure for Participants	Brochure WIC Participant_10.16.08.doc	10/16/2008
Letter to Participants from LWA	Letter from LWAs to Selected Participants.10.16.08.doc	10/16/2008
Spanish Letter to Participants from LWA	LW_ Letter from LWAs to Selected Participants 10 16 08_spa_final.doc	10/16/2008
Brochure for Participants (Spanish)	LW_Brochure WIC Participant_10 16 08_spa_final.doc	10/16/2008
Participant Consent Form (Spanish)	LW_Participant_consent.10.16.08_spa_final.doc	10/16/2008
Participant Consent Form	Participant_consent.10.16.08.doc	10/16/2008
Participant Consent Form (Spanish)	LW_Participant_consent.10.16.08_spa_final.doc	10/16/2008
Recruitment Letter to Sampled LWA	Recruit LWA letter.10.16.08.doc	10/16/2008
Abt follow-up letter to State Agencies	Abt follow-up letter to State Agencies.10.16.08.doc	10/16/2008

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