Information Collection

Travel Outreach Site Intercept Survey

IC 210421 under ICR 201303-0579-001 · OMB 0579-0377.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0579-0377 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
survey.docx	Other-Survey Template
template.docx Fast Track Template	IC Document

IC Title:

Travel Outreach Site Intercept Survey

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 7 CFR 300-499 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey Template			survey.docx		No		Paper Only

Line of Business: Natural Resources

Subfunction: Agricultural Innovation and Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,000	2,000
Annual IC Time Burden (Hours)	340	340
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fast Track Template	template.docx	02/25/2014

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