Information Collection

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

IC 221130 under ICR 201606-0584-004 · 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⚠️ Notice: This information collection may be referencing outdated material.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: Unchanged

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
	Requested	Previously Approved
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.