Information Collection

NSLP Verification II - SLT IC (IC 1 of 2)

IC 221130 under ICR 201407-0584-002 · OMB 0584-0524.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment A - Verification Letter_Simplifiedv2.docx	Other-Attachment A - Verification Le
Attachment B - Reminder Letterv2.docx	Other-Attachment B - Reminder Letter
Attachment C - Intervention Reminder Call Scriptv2.docx	Other-Attachment C - Intervention Re
Attachment D - Protocol for Participating LEAs.docx	Other-Attachment D - Protocol for Pa
Attachment E - Rolling Assignment Procedure Logic Model v2.docx	Other-Attachment E - Rolling Assignm
Attachment F - Report Template for HH Contact & Responses.xlsx	Other-Attachment F - Report Template
Attachment G - State Recruitment Letter.docx	Other-Attachment G - State Recruitme
Attachment H - LEA Recruitment Letter v2.docx	Other-Attachment H - LEA Recruitment
OMB package- FNS NSLP verification RCT v3.pdf NSLP Verification Year 2 - OMB Memo	IC Document

IC Title:

NSLP Verification II - SLT IC (IC 1 of 2)

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-Attachment A - Verification Letter_Simplified	Attachment A - Verification Letter_Simplifiedv2.docx	No	Paper Only
Other-Attachment B - Reminder Letter	Attachment B - Reminder Letterv2.docx	No	Paper Only
Other-Attachment C - Intervention Reminder Call Script	Attachment C - Intervention Reminder Call Scriptv2.docx	No	Paper Only
Other-Attachment D - Protocol for Participating LEAs	Attachment D - Protocol for Participating LEAs.docx	No	Paper Only
Other-Attachment E - Rolling Assignment Procedure Logic Model	Attachment E - Rolling Assignment Procedure Logic Model v2.docx	No	Paper Only
Other-Attachment F - Report Template for HH Contact & Responses	Attachment F - Report Template for HH Contact & Responses.xlsx	No	Paper Only
Other-Attachment G - State Recruitment Letter	Attachment G - State Recruitment Letter.docx	No	Paper Only
Other-Attachment H - LEA Recruitment Letter v2	Attachment H - LEA Recruitment Letter v2.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: 19

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	11,378	11,378
Annual IC Time Burden (Hours)	502	502
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
NSLP Verification Year 2 - OMB Memo	OMB package- FNS NSLP verification RCT v3.pdf	05/03/2016

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