HHFKA CACFP State Agencies

Generic Clearance to Conduct Formative Research

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0524 can be found here:

Documents and Forms

Document Name Document Type
Attachment A1_HHFKA Section 221 CACFP Phase 1_Pre-Notification to Participants_7 26 13.docx Other-Attachment A1 Pre-Notification
Attachment B1_HHFKA Section 221 CACFP Reminder Notification to Participants 7 26 13.docx Other-Attachment B1 REMINDER MESSAGE
Attachment E1_HHFKA CACFP Section 221 Master Focus Group Screener 7 26 13.docx Other-Attachment E1 FOCUS GROUP SCRE
Attachment F_HHFKA Section 221 CACFP Master FG Discussion Guide 7 26 13.docx Other-Attachment F CACFP Master FG D
Attachment D_HHFKA Section 221 CACFP FAQs 7 26 13.docx Other-Attachment D FAQ English
Attachment D-SPANISH_HHFKA Section 221 CACFP FAQs 7 26 13.docx Other-Attachment D Spanish FAQs
HHFKA Section 221 CACFP Formative Research OMB Package_8 02 13.docx OMB Generic Clearance Justification Memo IC Document
Burden Estimates HHFKS Section 221 CACFP 0524 7-29-13.xlsx Burden Estimates Excel Chart IC Document

Information Collection (IC) Details

IC Title:	HHFKA CACFP State Agencies	Agency IC Tracking Number:	Version 2

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-Attachment D Spanish FAQs	Attachment D-SPANISH_HHFKA Section 221 CACFP FAQs 7 26 13.docx	No	Paper Only
Other-Attachment A1 Pre-Notification to SA	Attachment A1_HHFKA Section 221 CACFP Phase 1_Pre-Notification to Participants_7 26 13.docx	No	Paper Only
Other-Attachment B1 REMINDER MESSAGE FOR STATE AND TRIBAL AGENCIES	Attachment B1_HHFKA Section 221 CACFP Reminder Notification to Participants 7 26 13.docx	No	Paper Only
Other-Attachment E1 FOCUS GROUP SCREENING AND DEMOGRAPHIC QUESTIONS for SA	Attachment E1_HHFKA CACFP Section 221 Master Focus Group Screener 7 26 13.docx	No	Paper Only
Other-Attachment F CACFP Master FG Discussion Guide	Attachment F_HHFKA Section 221 CACFP Master FG Discussion Guide 7 26 13.docx	No	Paper Only
Other-Attachment D FAQ English	Attachment D_HHFKA Section 221 CACFP FAQs 7 26 13.docx	No	Paper Only

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title: USDA/FNS-8 FNS Studies and Reports	FR Citation: 56 FR 19078

Number of Respondents: 60	Number of Respondents for Small Entity: 2

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	250	250
Annual IC Time Burden (Hours)	46	46
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
OMB Generic Clearance Justification Memo	HHFKA Section 221 CACFP Formative Research OMB Package_8 02 13.docx	09/05/2013
Burden Estimates Excel Chart	Burden Estimates HHFKS Section 221 CACFP 0524 7-29-13.xlsx	09/05/2013

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