Information Collection

Revised - Individuals/Households - Preparation for the Launch of the Summer Meals Study

IC 227339 under ICR 201503-0584-004 · OMB 0584-0606.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0606 can be found here:

2019-03-25 - Extension without change of a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix E.4. Household Eligibility Screener.docx	Other-Appendix E.4. Household Eligib
Appendix E.6 Participant Caregiver Survey.docx	Other-Appendix E.6 Participant Careg
Appendix E.7 Nonparticipant Caregiver Survey.docx	Other-Appendix E.7 Nonparticipant Ca
Appendix E.8 Participant Caregiver QI.docx	Other-Appendix E.8 Participant Careg
Appendix E.9 Nonparticipant Caregiver QI.docx	Other-Appendix E.9 Nonparticipant Ca
SFSP Generic Clearance Package_revised_6.29docx.docx SFSP Generic Clearance Package_revised_6.29docx.docx	IC Document
SFSP Burden Table Revised 6-28-17_aag.xlsx SFSP Burden Table Revised 6-28-17_aag	IC Document
Appendix E.1. Study voicemail message for inbound caregiver calls.docx Appendix E.1. Study voicemail message for inbound caregiver calls.docx	IC Document
Appendix E.2 Outbound telephone calls to schedule cognitive testing with caregivers.docx Appendix E.2 Outbound telephone calls to schedule cognitive testing with caregivers.docx	IC Document
Appendix E.3 Email caregivers confirmation for cognitive testing.docx Appendix E.3 Email caregivers confirmation for cognitive testing.docx	IC Document
Appendix E.5 Parental and 18 Year Old Consent Revised.docx Appendix E.5 Parental and 18 Year Old Consent Revised.docx	IC Document
Appendix E.10 Parental Consent to Interview Child or Teen Revised.docx Appendix E.10 Parental Consent to Interview Child or Teen Revised.docx	IC Document
Appendix E.11 Child Assent.docx Appendix E.11 Child Assent.docx	IC Document
Appendix E.12 Teen Assent.docx Appendix E.12 Teen Assent.docx	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Revised - Individuals/Households - Preparation for the Launch of the Summer Meals Study

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-Appendix E.4. Household Eligibility Screener.docx	Appendix E.4. Household Eligibility Screener.docx	No	Paper Only
Other-Appendix E.6 Participant Caregiver Survey.docx	Appendix E.6 Participant Caregiver Survey.docx	No	Paper Only
Other-Appendix E.7 Nonparticipant Caregiver Survey.docx	Appendix E.7 Nonparticipant Caregiver Survey.docx	No	Paper Only
Other-Appendix E.8 Participant Caregiver QI.docx	Appendix E.8 Participant Caregiver QI.docx	No	Paper Only
Other-Appendix E.9 Nonparticipant Caregiver QI.docx	Appendix E.9 Nonparticipant Caregiver QI.docx	No	Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title: FNS-8 USDA/FNS Studies and Reports

FR Citation: 56 FR 19078

Number of Respondents: 63

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	187	187
Annual IC Time Burden (Hours)	43	43
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SFSP Generic Clearance Package_revised_6.29docx.docx	SFSP Generic Clearance Package_revised_6.29docx.docx	06/29/2017
SFSP Burden Table Revised 6-28-17_aag	SFSP Burden Table Revised 6-28-17_aag.xlsx	06/29/2017
Appendix E.1. Study voicemail message for inbound caregiver calls.docx	Appendix E.1. Study voicemail message for inbound caregiver calls.docx	06/29/2017
Appendix E.2 Outbound telephone calls to schedule cognitive testing with caregivers.docx	Appendix E.2 Outbound telephone calls to schedule cognitive testing with caregivers.docx	06/29/2017
Appendix E.3 Email caregivers confirmation for cognitive testing.docx	Appendix E.3 Email caregivers confirmation for cognitive testing.docx	06/29/2017
Appendix E.5 Parental and 18 Year Old Consent Revised.docx	Appendix E.5 Parental and 18 Year Old Consent Revised.docx	06/29/2017
Appendix E.10 Parental Consent to Interview Child or Teen Revised.docx	Appendix E.10 Parental Consent to Interview Child or Teen Revised.docx	06/29/2017
Appendix E.11 Child Assent.docx	Appendix E.11 Child Assent.docx	06/29/2017
Appendix E.12 Teen Assent.docx	Appendix E.12 Teen Assent.docx	06/29/2017

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