Information Collection

Private Schools

IC 202591 under ICR 201204-0584-008 · OMB 0584-0570.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
CEO H Web Survey Title Screens for Buksiness for¬-for Profit Entities.docx www.opinionport.com	Other-AppH Web Survey Title Screens
CEO C_1 Administrative Cost Interview - Field Questionnaire.docx	Other-CEO C1 Administrative Cost Int
CEO C_2 Administrative Cost Interview - Self-Administered Questionnaire.docx	Other-CEO C2 Administrative Cost Int
CEO C_3 Application Data Form.docx	Other-CEO C3 Application Data Form
CEO C_5 Certification Record Abstraction Form.docx	Other-CEO C5 Certification Record Ab
CEO C_6 LEA FS Director Web Survey_ Non-Participating (EN).docx www.opinionport.com	Other-CEO C6 LEA FS Director Web Sur
CEO C_7 LEA FS Director Web Survey_Near Eligible (NE).docx www.opinionport.com	Other-CEO C7 LEA FS Director Web Sur
CEO C_8 LEA FS Director Web Survey_Participating (EP).docx www.opinionport.com	Other-CEO C8 LEA FS Director Web Sur
CEO C_12 LEA Meal Counting and Claiming Form_CEO.docx	Other-CEO C12 LEA Meal Counting and
CEO C_13 LEA Meal Counting and Claiming Form_Non-CEO.docx	Other-CEO C13 LEA Meal Counting and
CEO C_11 Meal and Cashier Observation Form.docx	Other-CEO C11 Meal and Cashier Obser
CEO C_9 Meal Count Verification Form _CEO.docx	Other-CEO C9 Meal Count Verification
CEO C_13 LEA Meal Counting and Claiming Form_Non-CEO.docx	Other-CEO C13 Meal Count Verificatio
CEO C_16 PEAR Web Survey of LEA FS Directors_Full version.docx www.opinionport.com	Other-CEO C16 PEAR Web Survey of LEA
CEO C_14 Menu Survey Instruction Booklet.docx	Other-CEO C14 Menu Survey Instructio
CEO C_15 Menu Survey.docx	Other-CEO C15 Menu Survey
CEO C_17 PEAR Web Survey of LEA FS Directors_Short version.docx www.opinionport.com	Other-CEO C17 PEAR Web Survey of LEA
CEO C_18 Pre-Visit LEA FS Director Questionnaire.docx	Other-CEO C18 Pre-Visit LEA FS Direc
CEO C_19 Pre-visit School Information Questionnaire.docx	Other-CEO C19 Pre-visit School Infor
CEO C_20 SEA Survey.docx	Other-CEO C20 SEA Survey
CEO C_21 State Child Nutrition Director Interview.docx	Other-CEO C21 State Child Nutrition
CEO D_1 LEA FS Director Web Survey_ Non-Participating (EN).docx www.opinionport.com	Other-CEO D1 LEA FS Director Web Sur
CEO D_2 LEA FS Director Web Survey_Near Eligible (NE).docx www.opinionport.com	Other-CEO D2 LEA FS Director Web Sur
CEO D_3 LEA FS Director Web Survey_Participating (EP).docx www.opinionport.com	Other-CEO D3 LEA FS Director Web Sur
CEO F_1 Advance Letters and Recruiting Package for Business for¬-for Profit Entities.docx AppF1 Advance Letters and Recruiting Package for Business for¬-for Profit Entities	IC Document
CEO C_4 Daily Reminder Card.docx CEO C4 Daily Reminder Card	IC Document
CEO E_4 FNS Letter of Support.doc CEO E4 FNS Letter of Support	IC Document
CEO E_5 MOU.doc CEO E5 MOU	IC Document
CEO E_7rev Recruiting Letter to LEAs for full data collection.docx CEO E7 Recruiting Letter to LEAs for full data collection	IC Document
CEO E_6rev Notification Letter to SEA.docx CEO E6 Notification Letter to SEA	IC Document
CEO E_8rev Recruiting Letter to LEAs for web & PEAR surveys.docx CEO E8 Recruiting Letter to LEAs for web & PEAR surveys	IC Document
CEO E_9rev Recruiting Letter to LEAs for web survey only.docx CEO E9 Recruiting Letter to LEAs for web survey only	IC Document
CEO E_10rev Recruiting Letter to LEAs for web, PEAR surveys, Adm Record Review & Cost Interviews.docx CEO E10 Recruiting Letter to LEAs for web, PEAR surveys, Adm Record Review & Cost Interviews	IC Document
CEO E_11rev Sample recruitment email from State to LEA (on-site data collection).doc CEO E11 Sample recruitment email from State to LEA (on-site data collection)	IC Document
CEO E_12rev Sample recruitment email from State to LEA (web survey).doc CEO E12 Sample recruitment email from State to LEA (web survey)	IC Document
CEO E_13rev State (Yr 1 & 2) follow-up email for on-site recruitment.docx CEO E13 State (Yr 1 & 2) follow-up email for on-site recruitment	IC Document
CEO E_14rev State (Yr 1 & 2) follow-up email for web survey recruitment.docx CEO E14 State (Yr 1 & 2) follow-up email for web survey recruitment	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Private Schools

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	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-CEO C21 State Child Nutrition Director Interview	CEO C_21 State Child Nutrition Director Interview.docx		No		Paper Only
Other-CEO D1 LEA FS Director Web Survey_ Non-Participating (EN)	CEO D_1 LEA FS Director Web Survey_ Non-Participating (EN).docx	www.opinionport.com	Yes	Yes	Fillable Fileable Signable
Other-CEO D2 LEA FS Director Web Survey_Near Eligible (NE)	CEO D_2 LEA FS Director Web Survey_Near Eligible (NE).docx	www.opinionport.com	Yes	Yes	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 C13 Meal Count Verification Form _Non-CEO	CEO C_13 LEA Meal Counting and Claiming Form_Non-CEO.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 C14 Menu Survey Instruction Booklet	CEO C_14 Menu Survey Instruction Booklet.docx		Yes	No	Paper Only
Other-CEO C15 Menu Survey	CEO C_15 Menu Survey.docx		No		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		Paper Only
Other-CEO C19 Pre-visit School Information Questionnaire	CEO C_19 Pre-visit School Information Questionnaire.docx		No		Paper Only
Other-CEO C20 SEA Survey	CEO C_20 SEA Survey.docx		No		Paper Only
Other-CEO D3 LEA FS Director Web Survey_Participating (EP)	CEO D_3 LEA FS Director Web Survey_Participating (EP).docx	www.opinionport.com	Yes	Yes	Fillable Fileable Signable
Other-AppH Web Survey Title Screens for Buksiness for&not-for Profit Entities	CEO H Web Survey Title Screens for Buksiness for&not-for Profit Entities.docx	www.opinionport.com	Yes	Yes	Fillable Fileable Signable
Other-CEO C1 Administrative Cost Interview - Field Questionnaire	CEO C_1 Administrative Cost Interview - Field Questionnaire.docx		No		Paper Only
Other-CEO C2 Administrative Cost Interview - Self-Administered Questionnaire	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 Abstraction 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		Yes	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		Yes	No	Paper Only
Other-CEO C11 Meal and Cashier Observation Form	CEO C_11 Meal and Cashier Observation Form.docx		No		Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 109

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

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

Percentage of Respondents Reporting Electronically: 68 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	109	109
Annual IC Time Burden (Hours)	60	60
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
AppF1 Advance Letters and Recruiting Package for Business for&not-for Profit Entities	CEO F_1 Advance Letters and Recruiting Package for Business for&not-for Profit Entities.docx	08/14/2012
CEO C4 Daily Reminder Card	CEO C_4 Daily Reminder Card.docx	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 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 E6 Notification Letter to SEA	CEO E_6rev Notification Letter to SEA.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.