View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	What You Can Do for School Wellness Communication Tools Testing	Agency IC Tracking Number:

IC Status: New

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	NA	NA	A_FNS screener_students_FINAL.docx		No		Paper Only
Form and Instruction	NA	NA	B_FNS screener_parents_FINAL.docx		No		Paper Only
Form and Instruction	NA	NA	C_Screener_Teachers_FINAL.docx		No		Paper Only
Form and Instruction	NA	NA	D_FNS screener_principals_FINAL.docx		No		Paper Only
Form and Instruction	NA	NA	E_Screener_Food Service Managers_FINAL.docx		No		Paper Only
Form and Instruction	NA	NA	F_Evaluative Guide_Students_FINAL.docx		No		Paper Only
Form and Instruction	NA	NA	G_Evaluative Guide_Parents_Final Revised.docx		No		Paper Only
Form and Instruction	NA	NA	H_Evaluative Guide_Teachers_Final Revised.docx		No		Paper Only
Form and Instruction	NA	NA	I_Evaluative Guide_Principals_Final Revised.docx		No		Paper Only
Form and Instruction	NA	NA	J_Evaluative Guide_Food Service Managers_Final Revised.docx		No		Paper Only
Form and Instruction	NA	NA	K_Attachment.pdf		No		Paper Only
Form and Instruction	NA	NA	L - Agreement on Security of Comments_Adults_FINAL.docx		No		Paper Only
Form and Instruction	NA	NA	M - Agreement on Security of Comments_parents_FINAL.docx		No		Paper Only
Form and Instruction	NA	NA	N - Parental consent form_FINAL.docx		No		Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,308	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	4,308	0	4,308	0	0	0
Annual IC Time Burden (Hours)	763	0	763	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Generic IC Request - Communications Tools Testing Memo (Second Phase)	OMB_Justification_Request.Evaluative_Stage_7_1_11.docx	07/12/2011

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