Information Collection

Business for- & not-for profit: Sponsors & Family Day Care,

IC 198847 under ICR 201108-0584-001 · OMB 0584-0566.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix B - Sponsor Recruitment and Data Forms 6-17-2011.doc	Other-Sponsor Materials
Appendix C- Family Day Care Home Recruitment and Data Forms (7-5-2011).doc	Other-Recruitment and Data Forms
Appendix D- On Site Observation Form 6-17-2011.doc	Other-Family Day Care Observation Fo
Appendix F - Child and Adult Care Food Program Provider Child Enrollment Data Abstraction Table 6-17-2011.doc	Other-Enrollment Data Sheet
Appendix B Sponsor Recruitment and Data Request Materials 1-30-2012.doc	Other-Appendix B Sponsor Recruitment
Appendix C Family Day Care Home Recruitment and Data Request Materials final 01-26-2012.doc	Other-Appendix C Family Day Care Hom
Appendix D On Site Observation Form 1-26-2012.doc	Other-Appendix D On Site Observation
Appendix F CACFP Provider Child Enrollment Data Abstraction Table 1-26-2012.doc	Other-Appendix F CACFP Provider Chil
Appendix B Sponsor Recruitment and Data Request Materials 2-14-2012.doc	Other-REV Appendix B Sponsor Recruit
Appendix C Family Day Care Home Recruitment and Data Request Materials final 2-14-2012.doc	Other-REV Appendix C Family Day Care
Appendix D On Site Observation Form 2-14-2012.doc	Other-REV Appendix D On Site Observa
Appendix F CACFP Provider Child Enrollment Data Abstraction Table 2-14-2012.doc	Other-REV Appendix F CACFP Provider

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	Available Electronically?	Electronic Capability
Other-Sponsor Materials	No	Paper Only
Other-Recruitment and Data Forms	No	Paper Only
Other-Family Day Care Observation Form	No	Paper Only
Other-Enrollment Data Sheet	No	Paper Only
Other-Appendix B Sponsor Recruitment and Data Request Materials 1-30-2012	No	Paper Only
Other-Appendix C Family Day Care Home Recruitment and Data Request Materials final 01-26-2012	No	Paper Only
Other-Appendix D On Site Observation Form 1-26-2012	No	Paper Only
Other-Appendix F CACFP Provider Child Enrollment Data Abstraction Table 1-26-2012	No	Paper Only
Other-REV Appendix B Sponsor Recruitment and Data Request Materials 2-14-2012	No	Paper Only
Other-REV Appendix C Family Day Care Home Recruitment and Data Request Materials final 2-14-2012	No	Paper Only
Other-REV Appendix D On Site Observation Form 2-14-2012	No	Paper Only
Other-REV Appendix F CACFP Provider Child Enrollment Data Abstraction Table 2-14-2012	No	Paper Only

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 245

Number of Respondents for Small Entity: 245

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

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	1,928	1,928
Annual IC Time Burden (Hours)	2,207	2,207
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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

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