Information Collection

Individual/Households

IC 202242 under ICR 201204-0584-007 · OMB 0584-0530.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0530 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
rev062112 Attachment M.1-Household Survey.doc	Other-M.1 Household Survey
rev062112 Attachment M.2-Household_Survey_Spanish.doc	Other-Attachment M.2-Household_Surve
rev062112 Attachment L.7-Consent for Access to Education Records_CEO.docm	Other-Attachment L.7-Consent for Acc
rev062112 Attachment L.8-Consent for Access to Education Records_CEO_Spanish.docm	Other-Attachment L.8-National School
rev062112 Attachment L.5-Informed Consent for Participation.docm	Other-Attachment L.5-Informed Consen
rev062112 Attachment L.6-Informed Consent for Participation_Spanish.docm	Other-Attachment L.6-Informed Consen
rev062112 Attachment L.1-HH Letter.doc Attachment L.1-HH Letter	IC Document
rev062112 Attachment L.2-HH Spanish Letter.doc Attachment L.2-HH Spanish Letter	IC Document
rev062112 Attachment L.3-National School Meals Brochure.doc Attachment L.3-National School Meals Brochure	IC Document
rev062112 Attachment L.4-National School Meals Brochure_Spanish.doc Attachment L.4-National School Meals Brochure_Spanish	IC Document

IC Title:

Individual/Households

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-M.1 Household Survey	rev062112 Attachment M.1-Household Survey.doc	No	Paper Only
Other-Attachment M.2-Household_Survey_Spanish	rev062112 Attachment M.2-Household_Survey_Spanish.doc	No	Paper Only
Other-Attachment L.7-Consent for Access to Education Records_CEO	rev062112 Attachment L.7-Consent for Access to Education Records_CEO.docm	No	Paper Only
Other-Attachment L.8-National School Meals Brochure_Spanish	rev062112 Attachment L.8-Consent for Access to Education Records_CEO_Spanish.docm	No	Paper Only
Other-Attachment L.5-Informed Consent for Participation	rev062112 Attachment L.5-Informed Consent for Participation.docm	No	Paper Only
Other-Attachment L.6-Informed Consent for Participation_Spanish	rev062112 Attachment L.6-Informed Consent for Participation_Spanish.docm	No	Paper Only

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title: FNS-8 USDA/FNS Studies and Reports

FR Citation: 65 FR 17251

Number of Respondents: 5,529

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	5,529	5,529
Annual IC Time Burden (Hours)	3,373	3,373
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment L.1-HH Letter	rev062112 Attachment L.1-HH Letter.doc	06/27/2012
Attachment L.2-HH Spanish Letter	rev062112 Attachment L.2-HH Spanish Letter.doc	06/27/2012
Attachment L.3-National School Meals Brochure	rev062112 Attachment L.3-National School Meals Brochure.doc	06/27/2012
Attachment L.4-National School Meals Brochure_Spanish	rev062112 Attachment L.4-National School Meals Brochure_Spanish.doc	06/27/2012

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