Information Collection

CACFP Characteristics - Businesses

IC 213733 under ICR 201411-0584-001 · OMB 0584-0601.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0601 can be found here:

2016-12-29 - No material or nonsubstantive change to a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
A2.2 ICCC Provider Instrument 092314.docx	Other-A2.2 ICCC Provider Instrument
A2.7 ICCC Provider Instrument 092314_Span.docx	Other-A2.7 ICCC Provider Instrument
A1.1 CCC Sponsor Instrument 092314.docx	Other-A1.1 CCC Sponsor Instrument 09
A1.4 Mixed Sponsor Instrument 092314.docx	Other-A1.4 Mixed Sponsor Instrument
A1.3 Head Start Sponsor Instrument 092314.docx	Other-A1.3 Head Start Sponsor Instru
A1.5 AR Sponsor Instrument 092314.docx	Other-A1.5 Sponsor Instrument 092314
A1.2 FDCH Sponsor Instrument 092314.docx	Other-A1.2 FDCH Sponsor Instrument 0
A2.1 CCC Provider Instrument 092314.docx	Other-A2.1 CCC Provider Instrument 0
A2.6 CCC Provider Instrument 092314_Span.docx	Other-A2.6 CCC Provider Instrument 0
A2.4 HS Provider Instrument 092314.docx	Other-A2.4 HS Provider Instrument 09
A2.9 HS Provider Instrument 092314_Span.docx	Other-A2.9 HS Provider Instrument 09
A2.5 AR Provider Instrument 092314.docx	Other-A2.5 AR Provider Instrument 09
A2.10 AR Provider Instrument 092314_Span.docx	Other-A2.10 AR Provider Instrument 0
A2.3 FDCH Provider Instrument 092314.docx	Other-A2.3 FDCH Provider Instrument
A2.8 FDCH Provider Instrument 092314_Span.docx	Other-A2.8 FDCH Provider Instrument
B3 Sponsor and Provider Recruitment Letters clean.docx B3 Sponsor and Provider Recruitment Letters clean	IC Document
B4 Sponsor and Provider Brochures clean.docx B4 Sponsor and Provider Brochures clean	IC Document
B5 Provider Recruitment Letter and Spanish Brochure_FINAL-Clean (1).docx B5 Provider Recruitment Letter and Spanish Brochure_FINAL-Clean (1)	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

CACFP Characteristics - Businesses

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	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-A2.2 ICCC Provider Instrument 092314	A2.2 ICCC Provider Instrument 092314.docx	Yes	Yes	Fillable Fileable
Other-A2.7 ICCC Provider Instrument 092314	A2.7 ICCC Provider Instrument 092314_Span.docx	Yes	Yes	Fillable Fileable
Other-A1.1 CCC Sponsor Instrument 092314	A1.1 CCC Sponsor Instrument 092314.docx	Yes	Yes	Fillable Fileable
Other-A1.4 Mixed Sponsor Instrument 092314	A1.4 Mixed Sponsor Instrument 092314.docx	Yes	Yes	Fillable Fileable
Other-A1.3 Head Start Sponsor Instrument 092314	A1.3 Head Start Sponsor Instrument 092314.docx	Yes	Yes	Fillable Fileable
Other-A1.5 Sponsor Instrument 092314	A1.5 AR Sponsor Instrument 092314.docx	Yes	Yes	Fillable Fileable
Other-A1.2 FDCH Sponsor Instrument 092314	A1.2 FDCH Sponsor Instrument 092314.docx	Yes	Yes	Fillable Fileable
Other-A2.1 CCC Provider Instrument 092314	A2.1 CCC Provider Instrument 092314.docx	Yes	Yes	Fillable Fileable
Other-A2.6 CCC Provider Instrument 092314_Span	A2.6 CCC Provider Instrument 092314_Span.docx	Yes	Yes	Fillable Fileable
Other-A2.4 HS Provider Instrument 092314	A2.4 HS Provider Instrument 092314.docx	Yes	Yes	Fillable Fileable
Other-A2.9 HS Provider Instrument 092314_Span	A2.9 HS Provider Instrument 092314_Span.docx	Yes	Yes	Fillable Fileable
Other-A2.3 FDCH Provider Instrument 092314	A2.3 FDCH Provider Instrument 092314.docx	Yes	Yes	Fillable Fileable
Other-A2.8 FDCH Provider Instrument 092314_Span	A2.8 FDCH Provider Instrument 092314_Span.docx	Yes	Yes	Fillable Fileable
Other-A2.5 AR Provider Instrument 092314	A2.5 AR Provider Instrument 092314.docx	Yes	Yes	Fillable Fileable
Other-A2.10 AR Provider Instrument 092314_Span	A2.10 AR Provider Instrument 092314_Span.docx	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,444

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 60 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,444	3,444
Annual IC Time Burden (Hours)	3,444	3,444
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
B3 Sponsor and Provider Recruitment Letters clean	B3 Sponsor and Provider Recruitment Letters clean.docx	03/31/2015
B4 Sponsor and Provider Brochures clean	B4 Sponsor and Provider Brochures clean.docx	03/31/2015
B5 Provider Recruitment Letter and Spanish Brochure_FINAL-Clean (1)	B5 Provider Recruitment Letter and Spanish Brochure_FINAL-Clean (1).docx	03/31/2015

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