Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Individuals/Households - Households Modified 75951 15385 0 Other-B6a. (Instrument E7) Household Survey Income Worksheet_v4_English
Other-B6b. (Instrument E7) Household Income Worksheet_Spanish
Other-B7a. (Instrument E10) Instructions for Inc Documentation After Survey_v6_English
Other-B7b. (Instrument E10) Instructions for Inc Documentation_Spanish
Other-Appendix B5a. Household Survey (English)
Other-Appendix B5b. Household Survey (Spanish)
Individuals/Households - Households (Non-Respondents) Unchanged 24876 259 0 Other-Non Respondents Burden Instrument
State, Local, and Tribal Government - State Child Nutrition Agency, SFA, and Schools Unchanged 14635 5235 0 Other-B1. (Instrument A5) SFA Request for E-Records_Part A Prior SY (Non-CEP Schools for Household Sampling)_v7
Other-B3. (Instrument A8) SFA Request for E-Records_Part B Current SY (Non-CEP Schools for Household Sampling)_v6
Other-B8. (Instrument A1) Application Data Abstraction Form_v4
Other-B9. (Instrument A2) SFA Request for E-Records (CEP Schools for ISP Data Abstraction)_v5
Other-B11. (Instrument A10) SFA Meal Participation Data Request_v4
Other-B12. (Instrument B3) SFA Director Web Survey_v6
Other-B13. (Instrument B1) SFA Pre Data Collection Visit_Questionnaire_v6
Other-B14. (Instrument B5) School_Pre Data Collection Visit_Questionnaire_v4
Other-B15. (Instrument D1) School Meal Count Verification Form_v5
Other-B16. (Instrument D3) SFA Meal Claim Reimbursement Verification Form_all schools_v4
Other-B17. (Instrument D4) State Meal Claim Data Request_v6
Other-B18. (Instrument C1). Meal Observation Booklet_v4
Other-C1. (Recruitment 003) Official Notification from Rgl Liaisons to State Dir_v6
Other-C2. (Recruitment 004) SFA Study Notification Template from State CN Director_v2
Other-C3. (Recruitment 005) SFA Study Notification and Data Request_v5
Other-C4. (Recruitment 006) SFA School Data Verification Reference Guide_v5
Other-C6. (Recruitment 007) SFA FU DiscGuide (Study Notification and School Data Verification)_v7
Other-C7. (Recruitment 008) Automated Email to Confirm Receipt of School Data_v5
Other-C8. (Recruitment 009) SFA Confirmation and Next Steps Email_v7
Other-C9. (Recruitment 010) SFA School Sample Notification Email_v7
Other-C10. (Recruitment 012) Email Notification Template from SFA to Schools_v6
Other-C11. (Recruitment 011) SFA Follow Up Discussion Guide (School Sample Notification)_v7
Other-C12. (Recruitment 013) School Study Notification Letter_v7
Other-C13. (Recruitment 014) School Follow Up Discussion Guide_v5
Other-C14. (Recruitment 015) School Confirmation Email_v7
Other-C15. (Recruitment 016) School Notification of HH Data Collection_v4
Other-C17. (Instrument B1a) SFA Data Collection Initial Visit Contact Email_v3
Other-C18. (Instrument B1b) SFA Data Collection Visit Confirmation Email_v3
Other-C20. (Instrument B5a) School Data Collection Visit Confirmation Email_v2
Other-C29. (Recruitment 100) Recruitment 100_APEC IV_Study Website Crosswalk_v7
State, Local, and Tribal Government - State Child Nutrition Agency, SFA, and Schools (Non-respondents) Unchanged 1474 38 0 Other-Non Respondents Burden Instrument
Total burden requested under this ICR: 116936 20917 0  
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