State Agencies

Child and Adult Care Food Program (CACFP) Improper Payment Meal Claims Assessment

Documents and Forms

Document Name Document Type
Appendix A2- State Agency Data Request Materials.pdf Other-State Agency Data Request Mate
Appendix A State Recruitment and Data Request Materials final 01-26-2012.doc Other-Appendix A State Recruitment a
Appendix A State Recruitment and Data Request Materials final 2-14-2012.doc Other-Appendix A State Recruitment a
Appendix A1 -- State Agency Contact Letter.pdf State Agency Contact Letter. IC Document

Information Collection (IC) Details

IC Title:	State Agencies	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-State Agency Data Request Materials	Appendix A2- State Agency Data Request Materials.pdf	No	Paper Only
Other-Appendix A State Recruitment and Data Request Materials final 01-26-2012	Appendix A State Recruitment and Data Request Materials final 01-26-2012.doc	No	Paper Only
Other-Appendix A State Recruitment and Data Request Materials final 2-14-2012	Appendix A State Recruitment and Data Request Materials final 2-14-2012.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: 16	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	30	30
Annual IC Time Burden (Hours)	19	19
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
State Agency Contact Letter.	Appendix A1 -- State Agency Contact Letter.pdf	08/12/2011

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