Information Collection

On-Site Food Service Manager Interview

IC 205445 under ICR 201301-0584-004 · OMB 0584-0562.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0562 can be found here:

Documents and Forms

Document Name Document Type
Appendix G1 Food Service Manager Interview.docx Other-Food Service Manager Interview
Appendix D10 SFA On-Site Invitation Letter.docx Appendix D10 SFA On-Site Invitation Letter IC Document
Appendix D11 SFA On-Site Confirmation Letter.docx Appendix D11 SFA On-Site Confirmation Letter IC Document
Appendix G2 Cafeteria Observation.docx Appendix G2 Cafeteria Observation IC Document
Appendix G3 Other Food Sources Checklist.docx Appendix G3 Other Food Sources Checklist IC Document
Appendix G4 Vending Machine Checklist.docx Appendix G4 Vending Machine Checklist IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	On-Site Food Service Manager Interview	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Food Service Manager Interview			Appendix G1 Food Service Manager Interview.docx		No		Paper Only

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 378	Number of Respondents for Small Entity: 4

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	628	628
Annual IC Time Burden (Hours)	274	274
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Appendix D10 SFA On-Site Invitation Letter	Appendix D10 SFA On-Site Invitation Letter.docx	02/05/2013
Appendix D11 SFA On-Site Confirmation Letter	Appendix D11 SFA On-Site Confirmation Letter.docx	02/05/2013
Appendix G2 Cafeteria Observation	Appendix G2 Cafeteria Observation.docx	02/05/2013
Appendix G3 Other Food Sources Checklist	Appendix G3 Other Food Sources Checklist.docx	02/05/2013
Appendix G4 Vending Machine Checklist	Appendix G4 Vending Machine Checklist.docx	02/05/2013

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