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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
State, Local, and Tribal Government - State Child Nutrition Agency, SFA, and Schools
Agency IC Tracking Number:
Is this a Common Form?
No
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
Other-B1. (Instrument A5) SFA Request for E-Records_Part A Prior SY (Non-CEP Schools for Household Sampling)_v7
B1. (Instrument A5) SFA Request for E-Records_Part A Prior SY (Non-CEP Schools for Household Sampling)_v7.docx
Yes
Yes
Fillable Fileable
Other-B3. (Instrument A8) SFA Request for E-Records_Part B Current SY (Non-CEP Schools for Household Sampling)_v6
B3. (Instrument A8) SFA Request for E-Records_Part B Current SY (Non-CEP Schools for Household Sampling)_v6.docx
Yes
Yes
Fillable Fileable
Other-B8. (Instrument A1) Application Data Abstraction Form_v4
B8. (Instrument A1) Application Data Abstraction Form_v4.docx
Yes
Yes
Fillable Fileable
Other-B9. (Instrument A2) SFA Request for E-Records (CEP Schools for ISP Data Abstraction)_v5
B9. (Instrument A2) SFA Request for E-Records (CEP Schools for ISP Data Abstraction)_v5.docx
Yes
Yes
Fillable Fileable
Other-B11. (Instrument A10) SFA Meal Participation Data Request_v4
B11. (Instrument A10) SFA Meal Participation Data Request_v4.docx
Yes
Yes
Fillable Fileable
Other-B12. (Instrument B3) SFA Director Web Survey_v6
B12. (Instrument B3) SFA Director Web Survey_v6.docx
Yes
Yes
Fillable Fileable
Other-B13. (Instrument B1) SFA Pre Data Collection Visit_Questionnaire_v6
B13. (Instrument B1) SFA Pre Data Collection Visit_Questionnaire_v6.docx
Yes
Yes
Fillable Fileable
Other-B14. (Instrument B5) School_Pre Data Collection Visit_Questionnaire_v4
B14. (Instrument B5) School_Pre Data Collection Visit_Questionnaire_v4.docx
Yes
Yes
Fillable Fileable
Other-B15. (Instrument D1) School Meal Count Verification Form_v5
B15. (Instrument D1) School Meal Count Verification Form_v5.docx
Yes
Yes
Fillable Fileable
Other-B16. (Instrument D3) SFA Meal Claim Reimbursement Verification Form_all schools_v4
B16. (Instrument D3) SFA Meal Claim Reimbursement Verification Form_all schools_v4.docx
Yes
Yes
Fillable Fileable
Other-B17. (Instrument D4) State Meal Claim Data Request_v6
B17. (Instrument D4) State Meal Claim Data Request_v6.docx
Yes
Yes
Fillable Fileable
Other-B18. (Instrument C1). Meal Observation Booklet_v4
B18. (Instrument C1). Meal Observation Booklet_v4.pdf
No
Paper Only
Other-C1. (Recruitment 003) Official Notification from Rgl Liaisons to State Dir_v6
C1. (Recruitment 003) Official Notification from Rgl Liaisons to State Dir_v6.docx
Yes
Yes
Fillable Fileable
Other-C2. (Recruitment 004) SFA Study Notification Template from State CN Director_v2
C2. (Recruitment 004) SFA Study Notification Template from State CN Director_v2.docx
Yes
Yes
Fillable Fileable
Other-C3. (Recruitment 005) SFA Study Notification and Data Request_v5
C3. (Recruitment 005) SFA Study Notification and Data Request_v5.docx
Yes
Yes
Fillable Fileable
Other-C4. (Recruitment 006) SFA School Data Verification Reference Guide_v5
C4. (Recruitment 006) SFA School Data Verification Reference Guide_v5.docx
Yes
Yes
Fillable Fileable
Other-C6. (Recruitment 007) SFA FU DiscGuide (Study Notification and School Data Verification)_v7
C6. (Recruitment 007) SFA FU DiscGuide (Study Notification and School Data Verification)_v7.docx
No
Paper Only
Other-C7. (Recruitment 008) Automated Email to Confirm Receipt of School Data_v5
C7. (Recruitment 008) Automated Email to Confirm Receipt of School Data_v5.docx
Yes
Yes
Fillable Fileable
Other-C8. (Recruitment 009) SFA Confirmation and Next Steps Email_v7
C8. (Recruitment 009) SFA Confirmation and Next Steps Email_v7.docx
Yes
No
Fillable Fileable
Other-C9. (Recruitment 010) SFA School Sample Notification Email_v7
C9. (Recruitment 010) SFA School Sample Notification Email_v7.docx
Yes
No
Fillable Fileable
Other-C10. (Recruitment 012) Email Notification Template from SFA to Schools_v6
C10. (Recruitment 012) Email Notification Template from SFA to Schools_v6.docx
Yes
Yes
Fillable Fileable
Other-C11. (Recruitment 011) SFA Follow Up Discussion Guide (School Sample Notification)_v7
C11. (Recruitment 011) SFA Follow Up Discussion Guide (School Sample Notification)_v7.docx
No
Paper Only
Other-C12. (Recruitment 013) School Study Notification Letter_v7
C12. (Recruitment 013) School Study Notification Letter_v7.docx
Yes
Yes
Fillable Fileable
Other-C13. (Recruitment 014) School Follow Up Discussion Guide_v5
C13. (Recruitment 014) School Follow Up Discussion Guide_v5.docx
No
Paper Only
Other-C14. (Recruitment 015) School Confirmation Email_v7
C14. (Recruitment 015) School Confirmation Email_v7.docx
Yes
Yes
Fillable Fileable
Other-C15. (Recruitment 016) School Notification of HH Data Collection_v4
C15. (Recruitment 016) School Notification of HH Data Collection_v4.docx
Yes
Yes
Fillable Fileable
Other-C17. (Instrument B1a) SFA Data Collection Initial Visit Contact Email_v3
C17. (Instrument B1a) SFA Data Collection Initial Visit Contact Email_v3.docx
Yes
Yes
Fillable Fileable
Other-C18. (Instrument B1b) SFA Data Collection Visit Confirmation Email_v3
C18. (Instrument B1b) SFA Data Collection Visit Confirmation Email_v3.docx
Yes
Yes
Fillable Fileable
Other-C20. (Instrument B5a) School Data Collection Visit Confirmation Email_v2
C20. (Instrument B5a) School Data Collection Visit Confirmation Email_v2.docx
Yes
Yes
Fillable Fileable
Other-C29. (Recruitment 100) Recruitment 100_APEC IV_Study Website Crosswalk_v7
C29. (Recruitment 100) Recruitment 100_APEC IV_Study Website Crosswalk_v7.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
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:
56 FR 19078
Number of Respondents:
1,098
Number of Respondents for Small Entity:
83
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
40 %
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
14,635
0
0
0
0
14,635
Annual IC Time Burden (Hours)
5,235
0
0
0
0
5,235
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
B19. Meal Observation Pilot Protocol_v2
B19. Meal Observation Pilot Protocol_v2.docx
02/09/2022
B2. (Instrument A6) SFA Reminder for E-Records Part A Prior SY (Non-CEP Schools for Household Sampling)_v6
B2. (Instrument A6) SFA Reminder for E-Records Part A Prior SY (Non-CEP Schools for Household Sampling)_v6.docx
02/09/2022
B4. (Instrument A9) SFA Reminder for E-Records Part B Current SY (Non-CEP Schools for Household Sampling)_v6
B4. (Instrument A9) SFA Reminder for E-Records Part B Current SY (Non-CEP Schools for Household Sampling)_v6.docx
02/09/2022
B10. (Instrument A3) SFA Reminder for E-Records (CEP Schools for ISP Data Abstraction)_v4
B10. (Instrument A3) SFA Reminder for E-Records (CEP Schools for ISP Data Abstraction)_v4.docx
02/09/2022
C5. (Recruitment 024) APEC-IV FAQ for States, SFAs, and Schools_v6
C5. (Recruitment 024) APEC-IV FAQ for States, SFAs, and Schools_v6.docx
02/09/2022
C19. (Instrument B2) SFA Data Collection Visit Reminder Email_v3
C19. (Instrument B2) SFA Data Collection Visit Reminder Email_v3.docx
02/09/2022
C21a. (Instrument B6) School Data Collection Visit Reminder Email_1 month
C21a. (Instrument B6) School Data Collection Visit Reminder Email_1 month.docx
02/09/2022
C21b. (Instrument B6) School Data Collection Visit Reminder Email_ 1 week
C21b. (Instrument B6) School Data Collection Visit Reminder Email_ 1 week.docx
02/09/2022
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.