Information Collection

Hussc-tn 2009

IC 187682 under ICR 200712-0584-003 · OMB 0584-0524.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FNS-781 HUSSC-TN 2009	Form and Instruction
FNS-781 Team Nutrition Enrollment Form TN Enrollment Form Nov 2008 - OMB Attachment A.doc	Form and Instruction
FNS-780 Healthier US School Challenge Application for Bronze or 2008 HUSSC Bronze-Silver Application 120408 OMB Attachment B.doc	Form and Instruction
FNS-779 HealthierUS School Challenge Application for Gold or Gol 2008 HUSSC Gold-Gold Distinction Application 112408 OMB Attachment C.doc	Form and Instruction
Change Justification Memo 12-5-08.doc Change Justification Memo	IC Document

IC Title:

HUSSC-TN 2009

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 7 CFR 227.37

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FNS-781	Team Nutrition Enrollment Form	TN Enrollment Form Nov 2008 - OMB Attachment A.doc	Yes	No	Fillable Printable
Form and Instruction	FNS-780	Healthier US School Challenge Application for Bronze or Silver Awards	2008 HUSSC Bronze-Silver Application 120408 OMB Attachment B.doc	Yes	No	Fillable Printable
Form and Instruction	FNS-779	HealthierUS School Challenge Application for Gold or Gold w/ Distinction Awards	2008 HUSSC Gold-Gold Distinction Application 112408 OMB Attachment C.doc	Yes	No	Fillable Printable

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,300

Number of Respondents for Small Entity: 300

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	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	2,300	0	0	0	0	0
Annual IC Time Burden (Hours)	1,233	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Change Justification Memo	Change Justification Memo 12-5-08.doc	12/29/2008

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