Generic Clearance to Conduct Formative Research

Forms and Documents

Document Name	Status
Form FNS 792 Consumer Research for Nutrition Education and Promotion Activities Form and Instruction	New
Dietary Guidelines Jan 05.pdf Supplementary Document	2006-12-27
Supporting Statement 3-30-2010.doc Supporting Statement A	2010-03-30

IC Document Collections

IC ID	Document Title	Status
192056	Consumer Research for Nutrition Education and Promotion Activities Form and Instruction	New

ICR Details

OMB Control No: 0584-0524	ICR Reference No: 201001-0584-004
Status: Historical Active	Previous ICR Reference No: 200712-0584-003
Agency/Subagency: USDA/FNS	Agency Tracking No:
Title: Generic Clearance to Conduct Formative Research
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/26/2010
	Date Received in OIRA: 03/30/2010
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2013	36 Months From Approved	04/30/2010
Responses	19,000	0	19,000
Time Burden (Hours)	7,008	0	7,008
Cost Burden (Dollars)	0	0	0

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Abstract: Information collection is necessary to obtain formative input on the development of nutrition education materials and related tools for population groups served by the U.S. Department of Agriculture

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Authorizing Statute(s): PL: Pub.L. 109 - 85 17 Name of Law: Child Nutrition Act of 1966
   PL: Pub.L. 108 - 269 17 Name of Law: Food Stamp Act of 1977
   PL: Pub.L. 107 - 249 202-215 Name of Law: Emergency Food Assistance Act of 1983
   PL: Pub.L. 107 - 293 5 Name of Law: Agriculture and Consumer Protection Act of 1973
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 55804	10/29/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 55	03/23/2010
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Consumer Research for Nutrition Education and Promotion Activities	FNS 803, FNS-793, FNS-779, FNS-780, FNS-781, FNS-791, FNS-790, FNS 808, FNS 809, FNS 810, FNS 811, FNS 792, FNS 812, FNS 804, FNS 805, FNS 813, FNS 807	Golden Grocer Award Nomination Form ,   User Response Form ,   Healthy Lifestyle User Response ,   Kids User Response ,   Power Partner Commitment ,   Power Panther Request and Agreement ,   Event Feedback (Power Panther) ,   Promote and Support Breastfeeding Feedback ,   Promote Fruits and Vegetables in Your Workplace ,   User Response Card ,   Activity Kit User Response Form ,   Team Nutrition School Enrollment Form ,   Gold Application for Recognizing Excellence in Nutrition and Physical Activity ,   Bronze/Silver Recognizing Excellence in Nutrition and Physical Activity ,   Hunger Champions Nomination Form ,   Promising Practices Submission Form ,   FNS Core Nutrition Messags Feedback Form

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	19,000	19,000	0	0	0	0
Annual Time Burden (Hours)	7,008	7,008	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $158,333

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 03/30/2010

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