OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

SNMCS State, Local & Tribal Governments

IC 211122 under ICR 201404-0584-003 · OMB 0584-0596.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
D1. Group 2—SFA Director Planning Interview.docx Other-D1. Group 2—SFA Director Plann
D2. Group 3—Foodservice Manager Pre-Visit Telephone Interview Questionnaire.docx Other-D2. Group 3—Foodservice Manage
D3. Group 3—School Principal Cost Interview Guide.doc Other-D3. Group 3—School Principal C
D4. Group 3—State Education Agency Finance Officer Indirect Cost Survey.docx Other-D4. Group 3—State Education Ag
D5. Group 3—SFA Follow-Up Cost Interview Preparation Form.doc Other-D5. Group 3—SFA Follow-Up Cost
D6. Group 3—SFA DirectorLEA Business Manager Foodservice Expense Statement Follow-Up.docx Other-D6. Group 3—SFA DirectorLEA Bu
D7. Group 3—SFA DirectorLEA Business Manager Foodservice Revenue Statement.docx Other-D7. Group 3—SFA DirectorLEA Bu
D8. Group 3—SFA DirectorLEA Business Manager SFA Indirect Cost Questionnaire – Follow-Up.docx Other-D8. Group 3—SFA DirectorLEA Bu
E1. Group 3—SFA Director Cost Interview Preparation Forms.doc Other-E1. Group 3—SFA Director Cost
E2. Group 3—SFA DirectorLEA Business Manager SFA Staffing and Operations Interview.docx Other-E2. Group 3—SFA DirectorLEA Bu
E3. Group 3—SFA DirectorLEA Business Manager SFA Indirect Cost Questionnaire—On-Site.docx Other-E3. Group 3—SFA DirectorLEA Bu
E4. Group 3—SFA DirectorLEA Business Manager Off-Budget District Staff Interview Guide revised 2014.05.23.doc Other-E4. Group 3—SFA DirectorLEA Bu
E5. Group 3—SFA DirectorLEA Business Manager Preliminary Foodservice Expense Statement revised 2014.05.23.docx Other-E5. Group 3—SFA DirectorLEA Bu
E6. Group 3—Foodservice Manager Cost Interview.docx Other-E6. Group 3—Foodservice Manage
E7. Group 3—SFA Food Cost Worksheet and Instructions.docx Other-E7. Group 3—SFA Food Cost Work
F1. Groups 1, 2, 3—SFA Director Survey.docx Other-F1. Groups 1, 2, 3—SFA Directo
F2. Groups 2, 3—FSM Survey.docx Other-F2. Groups 2, 3—FSM Survey
F3. Groups 2, 3—Principal Survey.docx Other-F3. Groups 2, 3—Principal Surv
H1. GROUP 2—BASIC MENU SURVEY.pdf Other-H1. GROUP 2—BASIC MENU SURVEY
H2. GROUP 2—EXPANDED MENU SURVEY.pdf Other-H2. GROUP 2—EXPANDED MENU SURV
H3. Group 2, 3—FSM A la Carte Foods Checklist (Basic and Expanded Menu Survey).docx Other-H3. Group 2, 3—FSM A la Carte
H4. Group 2, 3—FSM A la Carte Foods Checklist Instructions _Basic and Expanded Menu Survey_.pdf Other-H4. Group 2, 3—FSM A la Carte
I. Group 2—FSM Request for Data on Reimbursable Meal Sales.docx Other-I. Group 2—FSM Request for Dat
J. Groups 2, 3—Competitive Foods Training Module.pptx Other-J. Groups 2, 3—Competitive Foo
K1. Groups 2, 3—School Staff Liaison Vending Machine Form-Simple.docx Other-K1. Groups 2, 3—School Staff L
K2. Groups 2, 3—School Staff Liaison Vending Machine Form-Enhanced.docx Other-K2. Groups 2, 3—School Staff L
K3. Groups 2, 3—School Staff Liaison Other Sources Checklist revised 2014.05.23.docx Other-K3. Groups 2, 3—School Staff L
P1. Cafeteria Observation Guide (Interviewer-Completed).docx Other-P1. Cafeteria Observation Guid
P2. Group 2—Point of Sale Form (Interviewer-Completed).docx Other-P2. Group 2—Point of Sale Form
P4. Group 3—Plate Waste Observation Booklet (Interviewer-Completed).docx Other-P4. Group 3—Plate Waste Observ
C1 School Nutrition Association Endorsement Letter revised 2014.05.23.pdf
C1. School Nutrition Association Endorsement Letter		IC Document
C2. Groups 1, 2, 3—State Child Nutrition Director Study Introduction Email revised 2014.05.23.docx
C2. Groups 1, 2, 3—State Child Nutrition Director Study Introduction Email		IC Document
C3. Group 2—SFA Director Recruitment Advance Letter.docx
C3. Group 2—SFA Director Recruitment Advance Letter		IC Document
C4. Group 2—SFA Director Recruitment Confirmation Letter 2014.04.01.docx
C4. Group 2—SFA Director Recruitment Confirmation Letter 2014.04.01		IC Document
C5. Group 3—SFA Director Recruitment Advance Letter 2014.04.01.docx
C5. Group 3—SFA Director Recruitment Advance Letter 2014.04.01		IC Document
C6. Group 3—SFA Director Recruitment Confirmation Letter 2014.04.01.docx
C6. Group 3—SFA Director Recruitment Confirmation Letter 2014.04.01		IC Document
C7. Group 3—SFA Director Pre-Visit Advance Letter 2014.04.01.docx
C7. Group 3—SFA Director Pre-Visit Advance Letter 2014.04.01		IC Document
C8. Group 2—Foodservice Manager Introduction Letter.docx
C8. Group 2—Foodservice Manager Introduction Letter		IC Document
C9. Group 3—Foodservice Manager Introduction Letter.docx
C9. Group 3—Foodservice Manager Introduction Letter		IC Document
C10. Group 2—Principal Introduction Letter to Schools.docx
C10. Group 2—Principal Introduction Letter to Schools		IC Document
C11. Group 3—Principal Introduction Letter to Schools.docx
C11. Group 3—Principal Introduction Letter to Schools		IC Document
C12. Group 3—Principal Pre-Visit Advance Letter.docx
C12. Group 3—Principal Pre-Visit Advance Letter		IC Document
C13. Group 2—Recruiting Call Script rev 2014.05.22.docx
C13. Group 2—Recruiting Call Script 2014.04.01		IC Document
C14. Group 3—Recruiting Call Script 2014.04.01.docx
C14. Group 3—Recruiting Call Script 2014.04.01		IC Document
C15. Group 2—Study Overview.docx
C15. Group 2—Study Overview		IC Document
C16. Group 3—Study Overview.docx
C16. Group 2—Study Overview		IC Document
G1. Groups 1, 2, 3—SFA Director E-mail Invitation .docx
G1. Groups 1, 2, 3—SFA Director E-mail Invitation		IC Document
G2. Groups 2, 3—Principal E-mail Invitation.docx
G2. Groups 2, 3—Principal E-mail Invitation		IC Document
P3. Group 2—Milk Form (Interviewer-Completed).docx
P3. Group 2—Milk Form		IC Document

Information Collection (IC) Details

View Information Collection (IC)

layout table

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-D1. Group 2—SFA Director Planning Interview D1. Group 2—SFA Director Planning Interview.docx No   Paper Only
Other-D2. Group 3—Foodservice Manager Pre-Visit Telephone Interview Questionnaire D2. Group 3—Foodservice Manager Pre-Visit Telephone Interview Questionnaire.docx No   Paper Only
Other-D3. Group 3—School Principal Cost Interview Guide D3. Group 3—School Principal Cost Interview Guide.doc No   Paper Only
Other-D4. Group 3—State Education Agency Finance Officer Indirect Cost Survey D4. Group 3—State Education Agency Finance Officer Indirect Cost Survey.docx No   Paper Only
Other-D5. Group 3—SFA Follow-Up Cost Interview Preparation Form D5. Group 3—SFA Follow-Up Cost Interview Preparation Form.doc No   Paper Only
Other-D6. Group 3—SFA DirectorLEA Business Manager Foodservice Expense Statement Follow-Up D6. Group 3—SFA DirectorLEA Business Manager Foodservice Expense Statement Follow-Up.docx No   Paper Only
Other-D7. Group 3—SFA DirectorLEA Business Manager Foodservice Revenue Statement D7. Group 3—SFA DirectorLEA Business Manager Foodservice Revenue Statement.docx No   Paper Only
Other-D8. Group 3—SFA DirectorLEA Business Manager SFA Indirect Cost Questionnaire – Follow-Up D8. Group 3—SFA DirectorLEA Business Manager SFA Indirect Cost Questionnaire – Follow-Up.docx No   Paper Only
Other-E1. Group 3—SFA Director Cost Interview Preparation Forms E1. Group 3—SFA Director Cost Interview Preparation Forms.doc No   Paper Only
Other-E2. Group 3—SFA DirectorLEA Business Manager SFA Staffing and Operations Interview E2. Group 3—SFA DirectorLEA Business Manager SFA Staffing and Operations Interview.docx No   Paper Only
Other-E3. Group 3—SFA DirectorLEA Business Manager SFA Indirect Cost Questionnaire—On-Site E3. Group 3—SFA DirectorLEA Business Manager SFA Indirect Cost Questionnaire—On-Site.docx No   Paper Only
Other-E4. Group 3—SFA DirectorLEA Business Manager Off-Budget District Staff Interview Guide E4. Group 3—SFA DirectorLEA Business Manager Off-Budget District Staff Interview Guide revised 2014.05.23.doc No   Paper Only
Other-E5. Group 3—SFA DirectorLEA Business Manager Preliminary Foodservice Expense Statement E5. Group 3—SFA DirectorLEA Business Manager Preliminary Foodservice Expense Statement revised 2014.05.23.docx No   Paper Only
Other-E6. Group 3—Foodservice Manager Cost Interview E6. Group 3—Foodservice Manager Cost Interview.docx No   Paper Only
Other-E7. Group 3—SFA Food Cost Worksheet and Instructions E7. Group 3—SFA Food Cost Worksheet and Instructions.docx No   Paper Only
Other-F1. Groups 1, 2, 3—SFA Director Survey F1. Groups 1, 2, 3—SFA Director Survey.docx Yes Yes Fillable Fileable
Other-F2. Groups 2, 3—FSM Survey F2. Groups 2, 3—FSM Survey.docx Yes Yes Fillable Fileable
Other-F3. Groups 2, 3—Principal Survey F3. Groups 2, 3—Principal Survey.docx Yes Yes Fillable Fileable
Other-H1. GROUP 2—BASIC MENU SURVEY H1. GROUP 2—BASIC MENU SURVEY.pdf Yes Yes Fillable Fileable
Other-H2. GROUP 2—EXPANDED MENU SURVEY H2. GROUP 2—EXPANDED MENU SURVEY.pdf Yes Yes Fillable Fileable
Other-H3. Group 2, 3—FSM A la Carte Foods Checklist _Basic and Expanded Menu Survey H3. Group 2, 3—FSM A la Carte Foods Checklist (Basic and Expanded Menu Survey).docx Yes Yes Fillable Fileable
Other-H4. Group 2, 3—FSM A la Carte Foods Checklist Instructions _Basic and Expanded Menu Survey H4. Group 2, 3—FSM A la Carte Foods Checklist Instructions _Basic and Expanded Menu Survey_.pdf Yes Yes Fillable Fileable
Other-I. Group 2—FSM Request for Data on Reimbursable Meal Sales I. Group 2—FSM Request for Data on Reimbursable Meal Sales.docx No   Paper Only
Other-J. Groups 2, 3—Competitive Foods Training Module J. Groups 2, 3—Competitive Foods Training Module.pptx No   Paper Only
Other-K1. Groups 2, 3—School Staff Liaison Vending Machine Form-Simple K1. Groups 2, 3—School Staff Liaison Vending Machine Form-Simple.docx No   Paper Only
Other-K2. Groups 2, 3—School Staff Liaison Vending Machine Form-Enhanced K2. Groups 2, 3—School Staff Liaison Vending Machine Form-Enhanced.docx No   Paper Only
Other-K3. Groups 2, 3—School Staff Liaison Other Sources Checklist K3. Groups 2, 3—School Staff Liaison Other Sources Checklist revised 2014.05.23.docx No   Paper Only
Other-P1. Cafeteria Observation Guide P1. Cafeteria Observation Guide (Interviewer-Completed).docx No   Paper Only
Other-P2. Group 2—Point of Sale Form P2. Group 2—Point of Sale Form (Interviewer-Completed).docx No   Paper Only
Other-P4. Group 3—Plate Waste Observation Booklet P4. Group 3—Plate Waste Observation Booklet (Interviewer-Completed).docx No   Paper Only

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 16,521 0 16,521 0 0 0
Annual IC Time Burden (Hours) 17,957 0 17,957 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
C1. School Nutrition Association Endorsement Letter C1 School Nutrition Association Endorsement Letter revised 2014.05.23.pdf 06/13/2014
C2. Groups 1, 2, 3—State Child Nutrition Director Study Introduction Email C2. Groups 1, 2, 3—State Child Nutrition Director Study Introduction Email revised 2014.05.23.docx 06/13/2014
C3. Group 2—SFA Director Recruitment Advance Letter C3. Group 2—SFA Director Recruitment Advance Letter.docx 04/04/2014
C4. Group 2—SFA Director Recruitment Confirmation Letter 2014.04.01 C4. Group 2—SFA Director Recruitment Confirmation Letter 2014.04.01.docx 04/04/2014
C5. Group 3—SFA Director Recruitment Advance Letter 2014.04.01 C5. Group 3—SFA Director Recruitment Advance Letter 2014.04.01.docx 04/04/2014
C6. Group 3—SFA Director Recruitment Confirmation Letter 2014.04.01 C6. Group 3—SFA Director Recruitment Confirmation Letter 2014.04.01.docx 04/04/2014
C7. Group 3—SFA Director Pre-Visit Advance Letter 2014.04.01 C7. Group 3—SFA Director Pre-Visit Advance Letter 2014.04.01.docx 04/04/2014
C8. Group 2—Foodservice Manager Introduction Letter C8. Group 2—Foodservice Manager Introduction Letter.docx 04/04/2014
C9. Group 3—Foodservice Manager Introduction Letter C9. Group 3—Foodservice Manager Introduction Letter.docx 04/04/2014
C10. Group 2—Principal Introduction Letter to Schools C10. Group 2—Principal Introduction Letter to Schools.docx 04/04/2014
C11. Group 3—Principal Introduction Letter to Schools C11. Group 3—Principal Introduction Letter to Schools.docx 04/04/2014
C12. Group 3—Principal Pre-Visit Advance Letter C12. Group 3—Principal Pre-Visit Advance Letter.docx 04/04/2014
C13. Group 2—Recruiting Call Script 2014.04.01 C13. Group 2—Recruiting Call Script rev 2014.05.22.docx 06/13/2014
C14. Group 3—Recruiting Call Script 2014.04.01 C14. Group 3—Recruiting Call Script 2014.04.01.docx 04/04/2014
C15. Group 2—Study Overview C15. Group 2—Study Overview.docx 06/13/2014
C16. Group 2—Study Overview C16. Group 3—Study Overview.docx 06/13/2014
G1. Groups 1, 2, 3—SFA Director E-mail Invitation G1. Groups 1, 2, 3—SFA Director E-mail Invitation .docx 04/04/2014
G2. Groups 2, 3—Principal E-mail Invitation G2. Groups 2, 3—Principal E-mail Invitation.docx 04/04/2014
P3. Group 2—Milk Form P3. Group 2—Milk Form (Interviewer-Completed).docx 04/07/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.