FNS Core Nutrition Messages Concept Testing

Generic Clearance to Conduct Formative Research

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0524 can be found here:

Documents and Forms

Document Name Document Type
ATTCH A Focus Group Questionnaire Low-income Mom.doc Other-Questionnaire
ATTCH B Focus Group Questionnaire Low-income Child.doc Other-Questionnaire
ATTCH C Focus Group Mod Guide Low-Income Mom.doc Other-Moderator Guide
ATTCH D Focus Group Mod Guide Low-income Child.doc Other-Moderator Guide
ATTCH E Confidentiality Statement Low-income Mom.doc Other-Confidentiality Statement
ATTCH F Confidentiality Statement Low-income Child.doc Other-Confidentiality Statement
ATTCH G Parental Consent.doc Other-Parental Consent

Information Collection (IC) Details

IC Title:	FNS Core Nutrition Messages Concept Testing	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-Questionnaire	ATTCH A Focus Group Questionnaire Low-income Mom.doc	No	Paper Only
Other-Questionnaire	ATTCH B Focus Group Questionnaire Low-income Child.doc	No	Paper Only
Other-Moderator Guide	ATTCH C Focus Group Mod Guide Low-Income Mom.doc	No	Paper Only
Other-Moderator Guide	ATTCH D Focus Group Mod Guide Low-income Child.doc	No	Paper Only
Other-Confidentiality Statement	ATTCH E Confidentiality Statement Low-income Mom.doc	No	Paper Only
Other-Confidentiality Statement	ATTCH F Confidentiality Statement Low-income Child.doc	No	Paper Only
Other-Parental Consent	ATTCH G Parental Consent.doc	No	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,880	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	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	2,964	0	0	0	0	0
Annual IC Time Burden (Hours)	603	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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