Information Collection

District Food Service Administrator/Manager

IC 207891 under ICR 201307-0925-004 · OMB 0925-0649.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 11 District Food Service Administrator/Manager	Form and Instruction
11 School Food Environment Instrument FINAL_HCS_SSA_ATTACH 18_SCHOOL FOOD ENV SURVEY_Jan 2013.docx	Form and Instruction

IC Title:

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	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	11	School Food Environment Instrument	FINAL_HCS_SSA_ATTACH 18_SCHOOL FOOD ENV SURVEY_Jan 2013.docx		No	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 88

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	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	88	88
Annual IC Time Burden (Hours)	44	44
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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