Information Collection

Parent/Caregiver or Children - Club MyPlate Kindergarten Curriculum Formative Research

IC 207242 under ICR 201201-0584-026 · OMB 0584-0523.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0523 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment B_Parent Consent Package_FINAL.docx	Other-Attachment B: Parent Consent P
Attachment F_Moderators Guide for Parent Caregiver Focus Group_English and Spanish 08082013.docx	Other-Attachment F: Moderators Guide
Attachment G - Parent Caregiver Survey 06242013-2.docx	Other-Attachment G Parent Caregiver
Attachment H_Interview Guideline Children 06242013-1.docx	Other-Attachment H Interview Guideli
Attachment I_Individual Interview Storybook for Children_FINAL (2).pdf	Other-Attachment I Individual Interv
Attachment K_Parent Caregiver Follow Up Phone Call Script_06242013.docx	Other-Attachment K Parent Caregiver
Non Respondent Placeholder for Individual and Households.docx	Other-Non Respondent Placeholder
Attachment L_Parent Take Home Stimulus_English_Spanish.pdf	Other-Attachment L_Parent Take Home
CNY KG OMB Proposal_08052013 OCIO comments 8-22-13.docx CNY KG OMB Proposal_08052013	IC Document

IC Title:

Parent/Caregiver or Children - Club MyPlate Kindergarten Curriculum Formative Research

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 42 CFR 1755(a)(3) (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

table that charts list of instruments
Document Type	Available Electronically?	Electronic Capability
Other-Attachment B: Parent Consent Package	No	Paper Only
Other-Attachment F: Moderators Guide for Parent/Caregiver Focus Group	No	Paper Only
Other-Attachment G Parent Caregiver Survey	No	Paper Only
Other-Attachment H Interview Guideline Children	No	Paper Only
Other-Attachment I Individual Interview Storybook for Children	No	Paper Only
Other-Attachment K Parent Caregiver Follow Up Phone Call Script	No	Paper Only
Other-Non Respondent Placeholder	No	Paper Only
Other-Attachment L_Parent Take Home Stimulus_English_Spanish	No	Paper Only

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title: USDA/FNS 8 Report and Studies

FR Citation: 56 FR 19078

Number of Respondents: 240

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	480	480
Annual IC Time Burden (Hours)	1,553	1,553
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
CNY KG OMB Proposal_08052013		08/23/2013

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

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