Farmers Market Vendors Survey

Evaluation of Childhood Obesity Prevention and Control Initiative: New York City Healthy Bucks Program

Documents and Forms

Document Name Document Type
Farmers Market Vendors Survey Form
Farmers Market Vendors Survey Appendix E-1 Vendor Survey_01.21.10.doc Form
Appendix E-2 Vendor Fact Sheet_01.21.10.doc Fact Sheet for Farmers Market Vendors IC Document

Information Collection (IC) Details

IC Title:	Farmers Market Vendors Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Farmers Market Vendors Survey	Appendix E-1 Vendor Survey_01.21.10.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 450	Number of Respondents for Small Entity: 450

Affected Public: Private Sector	Private Sector: Farms

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	450	450
Annual IC Time Burden (Hours)	53	53
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Fact Sheet for Farmers Market Vendors	Appendix E-2 Vendor Fact Sheet_01.21.10.doc	03/31/2010

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