Direct Verification Evaluation Study

State Child Nutrition Agency Topics

OMB No. 0584-XXXX

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it
displays a valid OMB control number. The valid OMB control number for this information collection is 0584-XXXX. The time
required to complete this information collection is estimated to average 1.5 hours per response, including the time to review
instructions, search existing data sources, gathering and maintaining the data needed, and completing and reviewing the
collection of information. This information collection expires XX/XX/XXX.

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State Medicaid Agency Topics

OMB No. 0584-XXXX

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a
collection of information unless it displays a valid OMB control number. The valid OMB control
number for this information collection is 0584-XXXX. The time required to complete this
information collection is estimated to average 1.5 hours per response, including the time to
review instructions, search existing data sources, gathering and maintaining the data needed,
and completing and reviewing the collection of information. This information collection expires
XX/XX/XXX.

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