State, Local & Tribal LEA Schools

Community Eligibility Option Evaluation

OMB: 0584-0570

IC ID: 202590

Documents and Forms
Document Name
Document Type
Other-AppG Web Survey Title Screens
Other-CEO C1 Administrative Cost Int
Other-CEO C2 Administrative Cost Int
Other-CEO C3 Application Data Form
Other-CEO C5 Certification Record Ab
Other-CEO C6 LEA FS Director Web Sur
Other-CEO C7 LEA FS Director Web Sur
Other-CEO C8 LEA FS Director Web Sur
Other-CEO C12 LEA Meal Counting and
Other-CEO C13 LEA Meal Counting and
Other-CEO C11 Meal and Cashier Obser
Other-CEO C9 Meal Count Verification
Other-CEO C10 Meal Count Verificatio
Other-CEO C14 Menu Survey Instructio
Other-CEO C15 Menu Survey
Other-CEO C16 PEAR Web Survey of LEA
Other-CEO C17 PEAR Web Survey of LEA
Other-CEO C18 Pre-Visit LEA FS Direc
Other-CEO C19 Pre-visit School Infor
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

State, Local & Tribal LEA Schools
 
No New
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-CEO C14 Menu Survey Instruction Booklet CEO C_14 Menu Survey Instruction Booklet.docx No   Paper Only
Other-CEO C15 Menu Survey CEO C_15 Menu Survey.docx No   Paper Only
Other-CEO C16 PEAR Web Survey of LEA FS Directors_Full version CEO C_16 PEAR Web Survey of LEA FS Directors_Full version.docx www.opinionport.com Yes Yes Fillable Fileable Signable
Other-CEO C17 PEAR Web Survey of LEA FS Directors_Short version CEO C_17 PEAR Web Survey of LEA FS Directors_Short version.docx www.opinionport.com Yes Yes Fillable Fileable Signable
Other-CEO C18 Pre-Visit LEA FS Director Questionnaire CEO C_18 Pre-Visit LEA FS Director Questionnaire.docx No   Fillable Fileable Signable
Other-CEO C19 Pre-visit School Information Questionnaire CEO C_19 Pre-visit School Information Questionnaire.docx No   Paper Only
Other-AppG Web Survey Title Screens for State, Local and Tribal Government CEO G Web Survey Title Screens for State, Local and Tribal Government.docx www.opinionport.com Yes Yes Fillable Fileable Signable
Other-CEO C1 Administrative Cost Interview - Field Questionnaire 6-21-12 CEO C_1 Administrative Cost Interview - Field Questionnaire.docx No   Paper Only
Other-CEO C2 Administrative Cost Interview - Self-Administered Questionnaire 6-21-12 CEO C_2 Administrative Cost Interview - Self-Administered Questionnaire.docx No   Paper Only
Other-CEO C3 Application Data Form CEO C_3 Application Data Form.docx No   Paper Only
Other-CEO C5 Certification Record Abstration Form CEO C_5 Certification Record Abstraction Form.docx No   Paper Only
Other-CEO C6 LEA FS Director Web Survey_ Non-Participating (EN) CEO C_6 LEA FS Director Web Survey_ Non-Participating (EN).docx www.opinionport.com Yes Yes Fillable Fileable Signable
Other-CEO C7 LEA FS Director Web Survey_Near Eligible (NE) CEO C_7 LEA FS Director Web Survey_Near Eligible (NE).docx www.opinionport.com Yes Yes Fillable Fileable Signable
Other-CEO C8 LEA FS Director Web Survey_Participating (EP) CEO C_8 LEA FS Director Web Survey_Participating (EP).docx www.opinionport.com Yes Yes Fillable Fileable Signable
Other-CEO C12 LEA Meal Counting and Claiming Form_CEO CEO C_12 LEA Meal Counting and Claiming Form_CEO.docx No   Paper Only
Other-CEO C13 LEA Meal Counting and Claiming Form_Non-CEO CEO C_13 LEA Meal Counting and Claiming Form_Non-CEO.docx No   Fillable Fileable Signable
Other-CEO C11 Meal and Cashier Observation Form CEO C_11 Meal and Cashier Observation Form.docx No   Fillable Fileable Signable
Other-CEO C9 Meal Count Verification Form _CEO CEO C_9 Meal Count Verification Form _CEO.docx No   Paper Only
Other-CEO C10 Meal Count Verification Form _Non-CEO CEO C_10 Meal Count Verification Form _Non-CEO.docx No   Fillable Fileable Signable

Income Security Food and Nutrition Assistance

 

2,955 539
   
State, Local, and Tribal Governments
 
   68 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 3,904 0 3,904 0 0 0
Annual IC Time Burden (Hours) 2,214 0 2,214 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
CEO C4 Daily Reminder Card CEO C_4 Daily Reminder Card.docx 08/14/2012
CEO E1 CE Option Study Overview CEO E_1 CE Option Study Overview.docx 08/14/2012
CEO E2 CEO State CN Letter_Year1 States CEO E_2 CEO State CN Letter_Year1 States.doc 08/14/2012
CEO E3 CEO State CN Letter_Year2 States CEO E_3 CEO State CN Letter_Year2 States.doc 08/14/2012
CEO E4 FNS Letter of Support CEO E_4 FNS Letter of Support.doc 08/14/2012
CEO E5 MOU CEO E_5 MOU.doc 08/14/2012
CEO E6 Notification Letter to SEA CEO E_6rev Notification Letter to SEA.docx 08/14/2012
CEO E7 Recruiting Letter to LEAs for full data collection CEO E_7rev Recruiting Letter to LEAs for full data collection.docx 08/14/2012
CEO E8 Recruiting Letter to LEAs for web & PEAR surveys CEO E_8rev Recruiting Letter to LEAs for web & PEAR surveys.docx 08/14/2012
CEO E9 Recruiting Letter to LEAs for web survey only CEO E_9rev Recruiting Letter to LEAs for web survey only.docx 08/14/2012
CEO E10 Recruiting Letter to LEAs for web, PEAR surveys, Adm Record Review & Cost Interviews CEO E_10rev Recruiting Letter to LEAs for web, PEAR surveys, Adm Record Review & Cost Interviews.docx 08/14/2012
CEO E11 Sample recruitment email from State to LEA (on-site data collection) CEO E_11rev Sample recruitment email from State to LEA (on-site data collection).doc 08/14/2012
CEO E12 Sample recruitment email from State to LEA (web survey) CEO E_12rev Sample recruitment email from State to LEA (web survey).doc 08/14/2012
CEO E13 State (Yr 1 & 2) follow-up email for on-site recruitment CEO E_13rev State (Yr 1 & 2) follow-up email for on-site recruitment.docx 08/14/2012
CEO E14 State (Yr 1 & 2) follow-up email for web survey recruitment CEO E_14rev State (Yr 1 & 2) follow-up email for web survey recruitment.docx 08/14/2012
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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