National Household Food Acquisition and Purchase Survey

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Appdx X-Script for Initial Visit (Revised).pdf	Supplementary Document	Uploaded 2012-04-20	Available
FoodAPS Cognitive Test Memo.pdf	Supplementary Document	Uploaded 2012-04-20	Available
Appdx W-Script for Initial Visit (CogTest).pdf	Supplementary Document	Uploaded 2012-04-20	Available
Crosswalk memo.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2012-04-20	Available
Crosswalk for OMB passback on Food APS USDA ERS.pdf	Supplementary Document	Uploaded 2012-03-12	Available
L-Image of Handheld Scanner.pdf	Supplementary Document	Uploaded 2011-12-09	Available
V-Nonresponse Bias Analysis.pdf	Supplementary Document	Uploaded 2012-03-12	Available
U-Confidentiality Agreement.pdf	Supplementary Document	Uploaded 2011-12-09	Available
T-CIPSEA Pledge on Study Website.pdf	Supplementary Document	Uploaded 2011-12-09	Available
I-Magnet.pdf	Supplementary Document	Uploaded 2012-03-12	Available
G-Consent Form.pdf	Supplementary Document	Uploaded 2012-03-12	Available
F-Household Screener and hand cards.pdf	Supplementary Document	Uploaded 2012-03-12	Available
E-Study Brochure.pdf	Supplementary Document	Uploaded 2012-03-12	Available
D-Advance Postcard.pdf	Supplementary Document	Uploaded 2011-12-09	Available
C-TWG Recommendations.pdf	Supplementary Document	Uploaded 2011-12-08	Available
B-Field Test Results.pdf	Supplementary Document	Uploaded 2011-12-08	Available
A-Relationship of Collected Data to Study Objectives.pdf	Supplementary Document	Uploaded 2012-03-12	Available
OMB Part B.pdf	Supporting Statement B	Uploaded 2012-03-12	Available
OMB Part A.pdf	Supporting Statement A	Uploaded 2012-03-12	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
200402	National Food Acqusition and Purchase Survey -- Refusals/Non-respondents	Other-Refusal Conversion Letter	Unchanged
200401	National Household Food Acquisition and Purchase Survey -- Respondents	Other-Adult Food Booklet	Modified

ICR Details

OMB Control No: 0536-0068	ICR Reference No: 201204-0536-001
Status: Historical Active	Previous ICR Reference No: 201112-0536-001
Agency/Subagency: USDA/ERS	Agency Tracking No:
Title: National Household Food Acquisition and Purchase Survey
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 04/20/2012
	Date Received in OIRA: 04/20/2012
Terms of Clearance: ERS agrees to send a memoradum describing cognitive testing results of participant training received by Spanish languge speakers prior to conducting Spanish language participant training and information collection in the main study.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2015	03/31/2015	03/31/2015
Responses	221,202	0	221,202
Time Burden (Hours)	43,897	0	43,897
Cost Burden (Dollars)	0	0	0

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Abstract: ERS requests making non-substantive changes to survey recruitment approach based on cognitive test results for English speaking recruitment.

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Authorizing Statute(s): US Code: 7 USC 2026 Name of Law: Food and Nutrition Act of 2008
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 193	10/05/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 234	12/06/2011
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
National Food Acqusition and Purchase Survey -- Refusals/Non-respondents
National Household Food Acquisition and Purchase Survey -- Respondents

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ICR Summary of Burden

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	221,202	221,202	0	0	0	0
Annual Time Burden (Hours)	43,897	43,897	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $4,111,852

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 04/20/2012

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