Business Respondents: Grantees and Administrators/ Retailers/Local Community Org. Staff

Evaluation of Food Insecurity Nutrition Incentives (FINI)

Appendix AE.2. Annual Core Program Data Web Form Screenshots - English only

Business Respondents: Grantees and Administrators/ Retailers/Local Community Org. Staff

OMB: 0584-0616

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0584-0616 can be found here:

2018-12-19 - No material or nonsubstantive change to a currently approved collection
2017-11-08 - No material or nonsubstantive change to a currently approved collection

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Appendix AE.2

Annual Core Program Data Web Form

Screenshots – English Only

GRANTEE ANNUAL CORE DATA SURVEY

Shape1

At what type of outlets was the incentive program offered? (Select all that apply).

Shape2 Large Chain Grocery Store/Supermarket
Shape3 Discount Superstore
Shape4 Convenience Store
Shape5 Small Store or Corner Store
Shape6 Farmers Market
Shape7 Direct Farm
Shape8 Farm Stand
Shape9 Mobile market at single location
Shape10 Mobile market at multiple locations
Shape11 CSA

Shape12

Shape13

File Type	application/vnd.openxmlformats-officedocument.wordprocessingml.document
Author	Thomas Bosworth
File Modified	0000-00-00
File Created	2021-01-24