Information Collection Request

Generic Clearance to Conduct Formative Research

ICR 201008-0584-001 · OMB 0584-0524 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
What You Can Do for School Wellness Communication Tools Testing Form and Instruction New Available
What You Can Do for School Wellness Communication Tools Testing Form and Instruction New Repair queued
What You Can Do for School Wellness Communication Tools Testing Form and Instruction New Available
What You Can Do for School Wellness Communication Tools Testing Form and Instruction New Available
What You Can Do for School Wellness Communication Tools Testing Form and Instruction New Repair queued
What You Can Do for School Wellness Communication Tools Testing Form and Instruction New Available
What You Can Do for School Wellness Communication Tools Testing Form and Instruction New Available
What You Can Do for School Wellness Communication Tools Testing Form and Instruction New Available
What You Can Do for School Wellness Communication Tools Testing Form and Instruction New Available
What You Can Do for School Wellness Communication Tools Testing Form and Instruction New Available
What You Can Do for School Wellness Communication Tools Testing Form and Instruction New Available
What You Can Do for School Wellness Communication Tools Testing Form and Instruction New Available
What You Can Do for School Wellness Communication Tools Testing Form and Instruction New Available
What You Can Do for School Wellness Communication Tools Testing Form and Instruction New Available
Form FNS 817 Level III Feedback Form Form Unchanged Available
Form FNS 816 Level I Feedback Form Unchanged Available
Form FNS 780 Bronze/Silver Award Application Form and Instruction Unchanged Available
Form FNS 779 Gold/Gold Award of Distinction Application Form and Instruction Unchanged Available
Form FNS 812 Activity Kit User Response Form Form Unchanged Available
Form FNS 811 User Response Card Form Unchanged Available
Form FNS 810 Promote Fruits and Vegetables in Your Workplace Form Unchanged Repair queued
Form FNS 809 Promote and Support Breastfeeding Feedback Form Unchanged Available
Form FNS 808 Event Feedback (Power Panther) Form Unchanged Repair queued
Form FNS 807 Power Panther Request and Agreement Form Unchanged Available
Form FNS 813 Power Partner Commitment Form Unchanged Available
Form FNS 805 Kids User Response Form Unchanged Available
Form FNS 804 Healthy Lifestyle User Response Form Unchanged Available
Form FNS 803 User Response Form Form Unchanged Available
Form FNS 792 Golden Grocer Award Nomination Form Form and Instruction Unchanged Available
Form FNS-793 FNS Core Nutrition Messags Feedback Form Form and Instruction Unchanged Available
Form FNS-791 Promising Practices Submission Form Form and Instruction Unchanged Available
Form FNS-790 Hunger Champions Nomination Form Form and Instruction Unchanged Available
Form FNS-780 Bronze/Silver Recognizing Excellence in Nutrition and Physical Activity Form and Instruction Unchanged Available
Form FNS-779 Gold Application for Recognizing Excellence in Nutrition and Physical Activity Form and Instruction Unchanged Available
Form FNS-781 Team Nutrition School Enrollment Form Form and Instruction Unchanged Available
change justification memo 8-2-2010.docx Justification for No Material/Nonsubstantive Change Uploaded 2010-08-04 Available
HUSSC change justification memo 7-8-2010.docx Justification for No Material/Nonsubstantive Change Uploaded 2010-07-12 Available
Dietary Guidelines Jan 05.pdf Supplementary Document Uploaded 2006-12-27 Repair queued
Supporting Statement 3-30-2010.doc Supporting Statement A Uploaded 2010-03-30 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
202851 HUSSC 2012 Other-FNS-780 2012 HUSSC Bronze-Silver Application New
202026 MyPlate Parent/Student REV Other-Attachment B - Parent Letter_Response Form_Consent Form fo New
201535 MyPlate Other-Attachment A - Teacher Letter_Response Form_Consent Form New
200916 Zero Income (I/H) Other-Attachment A1 - Interview Guide - English New
200681 Team Nutrtition Curriculum Messages for 5 & 6th Grades (I/H) Other-Attachment C New
200504 Team Nutrition Curriculum Messages for 5 & 6th Grades (SA) Other-Teacher Letter Teacher Respnse Teacher Consent New
200310 Zero Income (SA) Other-Recruitment Letter to states New
198917 Team Nutrition Curriculum (State Agencies: Teachers & Foodservice Staff) Other-Protocol for Administration of Student Pretest New
198840 Team Nutrition Curriculum (I/H) Other-Student Pretest New
198156 What You Can Do for School Wellness Communication Tools Testing Form and Instruction NewNA
198156 What You Can Do for School Wellness Communication Tools Testing Form and Instruction NewNA
198156 What You Can Do for School Wellness Communication Tools Testing Form and Instruction NewNA
198156 What You Can Do for School Wellness Communication Tools Testing Form and Instruction NewNA
198156 What You Can Do for School Wellness Communication Tools Testing Form and Instruction NewNA
198156 What You Can Do for School Wellness Communication Tools Testing Form and Instruction NewNA
198156 What You Can Do for School Wellness Communication Tools Testing Form and Instruction NewNA
198156 What You Can Do for School Wellness Communication Tools Testing Form and Instruction NewNA
198156 What You Can Do for School Wellness Communication Tools Testing Form and Instruction NewNA
198156 What You Can Do for School Wellness Communication Tools Testing Form and Instruction NewNA
198156 What You Can Do for School Wellness Communication Tools Testing Form and Instruction NewNA
198156 What You Can Do for School Wellness Communication Tools Testing Form and Instruction NewNA
198156 What You Can Do for School Wellness Communication Tools Testing Form and Instruction NewNA
198156 What You Can Do for School Wellness Communication Tools Testing Form and Instruction NewNA
195938 Team Nutrition Gardens Formative Research Other-Focus Group Moderator Guide New
195334 Healthy School Environment Other-Screening Questionnaire New
194845 Core Nutrition Messages - Revised Other-Triad Screening questionnaire Low-Income Mothers New
192056 Consumer Research for Nutrition Education and Promotion Activities Form UnchangedLevel III Feedback Form
192056 Consumer Research for Nutrition Education and Promotion Activities Form UnchangedLevel I Feedback
192056 Consumer Research for Nutrition Education and Promotion Activities Form and Instruction UnchangedBronze/Silver Award Application
192056 Consumer Research for Nutrition Education and Promotion Activities Form and Instruction UnchangedGold/Gold Award of Distinction Application
192056 Consumer Research for Nutrition Education and Promotion Activities Form UnchangedActivity Kit User Response Form
192056 Consumer Research for Nutrition Education and Promotion Activities Form UnchangedUser Response Card
192056 Consumer Research for Nutrition Education and Promotion Activities Form UnchangedPromote Fruits and Vegetables in Your Workplace
192056 Consumer Research for Nutrition Education and Promotion Activities Form UnchangedPromote and Support Breastfeeding Feedback
192056 Consumer Research for Nutrition Education and Promotion Activities Form UnchangedEvent Feedback (Power Panther)
192056 Consumer Research for Nutrition Education and Promotion Activities Form UnchangedPower Panther Request and Agreement
192056 Consumer Research for Nutrition Education and Promotion Activities Form UnchangedPower Partner Commitment
192056 Consumer Research for Nutrition Education and Promotion Activities Form UnchangedKids User Response
192056 Consumer Research for Nutrition Education and Promotion Activities Form UnchangedHealthy Lifestyle User Response
192056 Consumer Research for Nutrition Education and Promotion Activities Form UnchangedUser Response Form
192056 Consumer Research for Nutrition Education and Promotion Activities Form and Instruction UnchangedGolden Grocer Award Nomination Form
192056 Consumer Research for Nutrition Education and Promotion Activities Form and Instruction UnchangedFNS Core Nutrition Messags Feedback Form
192056 Consumer Research for Nutrition Education and Promotion Activities Form and Instruction UnchangedPromising Practices Submission Form
192056 Consumer Research for Nutrition Education and Promotion Activities Form and Instruction UnchangedHunger Champions Nomination Form
192056 Consumer Research for Nutrition Education and Promotion Activities Form and Instruction UnchangedBronze/Silver Recognizing Excellence in Nutrition and Physical Activity
192056 Consumer Research for Nutrition Education and Promotion Activities Form and Instruction UnchangedGold Application for Recognizing Excellence in Nutrition and Physical Activity
192056 Consumer Research for Nutrition Education and Promotion Activities Form and Instruction UnchangedTeam Nutrition School Enrollment Form
192056 Consumer Research for Nutrition Education and Promotion Activities Other-Screening Guide Unchanged

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
04/30/2013 04/30/2013 04/30/2013
57,000 0 38,000
21,016 0 14,000
0 0 0





Reginfo record details
14
table that charts list of burden
IC Title Form No. Form Name
Consumer Research for Nutrition Education and Promotion Activities FNS 780, FNS 816, FNS 779, FNS 817, FNS 804, FNS 805, FNS 813, FNS 807, FNS 808, FNS 809, FNS 810, FNS 811, FNS 792, FNS 812, FNS 803, FNS-793, FNS-779, FNS-780, FNS-781, FNS-791, FNS-790 ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,  
Core Nutrition Messages - Revised
HUSSC 2012
Healthy School Environment
MyPlate
MyPlate Parent/Student REV
Team Nutrition Curriculum (I/H)
Team Nutrition Curriculum (State Agencies: Teachers & Foodservice Staff)
Team Nutrition Curriculum Messages for 5 & 6th Grades (SA)
Team Nutrition Gardens Formative Research
Team Nutrtition Curriculum Messages for 5 & 6th Grades (I/H)
What You Can Do for School Wellness Communication Tools Testing NA, NA, NA, NA, NA, NA, NA, NA, NA, NA, NA, NA, NA, NA ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,  
Zero Income (I/H)
Zero Income (SA)

table that charts list 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 57,000 38,000 0 19,000 0 0
Annual Time Burden (Hours) 21,016 14,000 0 7,016 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No