Information Collection

Schools Principals, Teachers, State Directors, SFA, SFSM

IC 191486 under ICR 200911-0584-007 · OMB 0584-0556.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
AppendixC CNA survey.doc	Other-Survey
AppendixD SFA survey 1-6-10.doc	Other-Survey
AppendixE Principal survey 1-5-10.doc	Other-Survey
AppendixF Food environment assessment.doc	Other-Survey
AppendixG Food Mgr interview.doc	Other-Survey
AppendixH Teacher survey.doc	Other-Survey

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey	AppendixC CNA survey.doc	Yes	Yes	Fillable Fileable Signable
Other-Survey	AppendixD SFA survey 1-6-10.doc	Yes	Yes	Fillable Fileable Signable
Other-Survey	AppendixE Principal survey 1-5-10.doc	Yes	Yes	Fillable Fileable Signable
Other-Survey	AppendixF Food environment assessment.doc	No		Paper Only
Other-Survey	AppendixG Food Mgr interview.doc	No		Paper Only
Other-Survey	AppendixH Teacher survey.doc	No		Paper Only

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,726

Number of Respondents for Small Entity: 40

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 10 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,050	3,050
Annual IC Time Burden (Hours)	891	891
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.