Addendum to FoodAPS-2 Pilot Study

Generic Clearance for Questionnaire Pretesting Research

Documents and Forms

Document Name Document Type
Form 1 Addendum to FoodAPS-2 Pilot Study Form and Instruction
1 Updated Screener Appendix D Screener Questionnaire for Participant Recruitment revision 20240226.docx Form and Instruction
Addendum to FoodAPS OMB request 20240226.docx Addendum OMB Memo IC Document
OMB request for FoodAPS-2 Pilot Test usability evaluation revision 20240212.docx Originial OMB Memo request IC Document
Appendix F Adult Consent Form_tracked_20240226.docx Consent Form Updated IC Document

Information Collection (IC) Details

IC Title:	Addendum to FoodAPS-2 Pilot Study	Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Updated Screener	Appendix D Screener Questionnaire for Participant Recruitment revision 20240226.docx		No		Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

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

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	1	1
Annual IC Time Burden (Hours)	0	0
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Addendum OMB Memo	Addendum to FoodAPS OMB request 20240226.docx	02/26/2024
Originial OMB Memo request	OMB request for FoodAPS-2 Pilot Test usability evaluation revision 20240212.docx	02/26/2024
Consent Form Updated	Appendix F Adult Consent Form_tracked_20240226.docx	02/26/2024

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