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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Revised - Individuals/Households - Preparation for the Launch of the Summer Meals Study
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
Other-Appendix E.4. Household Eligibility Screener.docx
Appendix E.4. Household Eligibility Screener.docx
No
Paper Only
Other-Appendix E.6 Participant Caregiver Survey.docx
Appendix E.6 Participant Caregiver Survey.docx
No
Paper Only
Other-Appendix E.7 Nonparticipant Caregiver Survey.docx
Appendix E.7 Nonparticipant Caregiver Survey.docx
No
Paper Only
Other-Appendix E.8 Participant Caregiver QI.docx
Appendix E.8 Participant Caregiver QI.docx
No
Paper Only
Other-Appendix E.9 Nonparticipant Caregiver QI.docx
Appendix E.9 Nonparticipant Caregiver QI.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:
FNS-8 USDA/FNS Studies and Reports
FR Citation:
56 FR 19078
Number of Respondents:
63
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
187
0
187
0
0
0
Annual IC Time Burden (Hours)
43
0
43
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
SFSP Generic Clearance Package_revised_6.29docx.docx
SFSP Generic Clearance Package_revised_6.29docx.docx
06/29/2017
SFSP Burden Table Revised 6-28-17_aag
SFSP Burden Table Revised 6-28-17_aag.xlsx
06/29/2017
Appendix E.1. Study voicemail message for inbound caregiver calls.docx
Appendix E.1. Study voicemail message for inbound caregiver calls.docx
06/29/2017
Appendix E.2 Outbound telephone calls to schedule cognitive testing with caregivers.docx
Appendix E.2 Outbound telephone calls to schedule cognitive testing with caregivers.docx
06/29/2017
Appendix E.3 Email caregivers confirmation for cognitive testing.docx
Appendix E.3 Email caregivers confirmation for cognitive testing.docx
06/29/2017
Appendix E.5 Parental and 18 Year Old Consent Revised.docx
Appendix E.5 Parental and 18 Year Old Consent Revised.docx
06/29/2017
Appendix E.10 Parental Consent to Interview Child or Teen Revised.docx
Appendix E.10 Parental Consent to Interview Child or Teen Revised.docx
06/29/2017
Appendix E.11 Child Assent.docx
Appendix E.11 Child Assent.docx
06/29/2017
Appendix E.12 Teen Assent.docx
Appendix E.12 Teen Assent.docx
06/29/2017
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.