Information Collection

Farmers Market Consumer Survey

IC 192693 under ICR 201004-0920-009 · OMB 0920-0855.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Farmers Market Consumer Survey	Form
Farmers Market Consumer Survey Appendix G-1 Consumer Survey_01.21.10.doc	Form
Appendix G-2 Consumer Fact Sheet_01.21.10.doc Fact Sheet for Farmers Market Consumers	IC Document

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	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Farmers Market Consumer Survey	Appendix G-1 Consumer 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: 2,300

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,300	2,300
Annual IC Time Burden (Hours)	268	268
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fact Sheet for Farmers Market Consumers	Appendix G-2 Consumer Fact Sheet_01.21.10.doc	04/01/2010

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