Information Collection

Large Retailers (Respondents)

IC 227738 under ICR 201707-0584-001 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix C1.1 Screenshots of Company Survey 9_22.docx survey.gatorzone.com	Other-Appendix C1.1 Screenshots of C
Appendix C2.1 Screenshots of Store Survey 9_22.docx survey.gatorzone.com	Other-Appendix C2.1 Screenshots of S
Appendix C1 Large SNAP Company Survey 9_22.docx survey.gatorzone.com	Other-Appendix C1 Large SNAP Company
Appendix C2 Large SNAP Store Survey 9_22.docx survey.gatorzone.com	Other-Appendix C2 Large SNAP Store S
Revised 8_1 Appendix D1 FNS Survey Pre-Notification for Company Representatives.docx Revised 8_1 Appendix D1 FNS Survey Pre-Notification for Company Representatives.docx	IC Document
Revised 8_1 Appendix D2 FNS Pre-Notification for Store Managers.docx Revised 8_1 Appendix D2 FNS Pre-Notification for Store Managers.docx	IC Document
Revised 8_1 Appendix D3 Company Survey Announcement.docx Revised 8_1 Appendix D3 Company Survey Announcement.docx	IC Document
Revised 9-27 Appendix D3.1 Company Recruitment Call Script.docx Revised 9_27 Appendix D3.1 Company Recruitment Call Script.docx	IC Document
Revised 8_30 Appendix D3.2 Company Referral Call Script.docx Revised 8_30 Appendix D3.2 Company Referral Call Script.docx	IC Document
Revised 8_1 Appendix D3.3 Suggested Text for Company Authorization of Stores.docx Revised 8_1 Appendix D3.3 Suggested Text for Company Authorization of Stores.docx	IC Document
Revised 8_7 Appendix D4 Store Survey Announcement.docx Appendix D4 Store Survey Announcement.docx	IC Document
Revised 8_7 Appendix D5 Company Survey Reminder Email.rtf Appendix D5 Company Survey Reminder Email.rtf	IC Document
Revised 8_1 Appendix D6 Store Survey Reminder Email.docx Revised 8_1 Appendix D6 Store Survey Reminder Email.docx	IC Document
Appendix D7 Company Survey Nonresponder Call Script 9_22.docx Appendix D7 Company Survey Nonresponder Call Scrip 9_22t.docx	IC Document
Appendix D8 Store Survey Nonresponder Call Script 9_22.docx Appendix D8 Store Survey Nonresponder Call Script 9_22.docx	IC Document
Appendix E Call Training Description.docx Appendix E Call Training Description.docx	IC Document
Appendix F1 Company Pretest Instrument 9_22.docx Appendix F1 Company Pretest Instrument 9_22.docx	IC Document
Appendix F2 Store Pretest Instrument 9_22.docx Appendix F2 Store Pretest Instrument 9_22	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Large Retailers (Respondents)

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Appendix C1.1 Screenshots of Company Survey.docx	Appendix C1.1 Screenshots of Company Survey 9_22.docx	http://survey.gatorzone.com	Yes	Yes	Fillable Fileable Signable
Other-Appendix C2.1 Screenshots of Store Survey.docx	Appendix C2.1 Screenshots of Store Survey 9_22.docx	http://survey.gatorzone.com	Yes	Yes	Fillable Fileable Signable
Other-Appendix C1 Large SNAP Company Survey.docx	Appendix C1 Large SNAP Company Survey 9_22.docx	http://survey.gatorzone.com	Yes	Yes	Fillable Fileable Signable
Other-Appendix C2 Large SNAP Store Survey.docx	Appendix C2 Large SNAP Store Survey 9_22.docx	http://survey.gatorzone.com	Yes	Yes	Fillable Fileable Signable

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: 1,689

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,689	1,689
Annual IC Time Burden (Hours)	2,811	2,811
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Revised 8_1 Appendix D1 FNS Survey Pre-Notification for Company Representatives.docx	Revised 8_1 Appendix D1 FNS Survey Pre-Notification for Company Representatives.docx	08/03/2017
Revised 8_1 Appendix D2 FNS Pre-Notification for Store Managers.docx	Revised 8_1 Appendix D2 FNS Pre-Notification for Store Managers.docx	08/03/2017
Revised 8_1 Appendix D3 Company Survey Announcement.docx	Revised 8_1 Appendix D3 Company Survey Announcement.docx	08/03/2017
Revised 9_27 Appendix D3.1 Company Recruitment Call Script.docx	Revised 9-27 Appendix D3.1 Company Recruitment Call Script.docx	09/27/2017
Revised 8_30 Appendix D3.2 Company Referral Call Script.docx	Revised 8_30 Appendix D3.2 Company Referral Call Script.docx	08/30/2017
Revised 8_1 Appendix D3.3 Suggested Text for Company Authorization of Stores.docx	Revised 8_1 Appendix D3.3 Suggested Text for Company Authorization of Stores.docx	08/03/2017
Appendix D4 Store Survey Announcement.docx	Revised 8_7 Appendix D4 Store Survey Announcement.docx	08/09/2017
Appendix D5 Company Survey Reminder Email.rtf	Revised 8_7 Appendix D5 Company Survey Reminder Email.rtf	08/09/2017
Revised 8_1 Appendix D6 Store Survey Reminder Email.docx	Revised 8_1 Appendix D6 Store Survey Reminder Email.docx	08/03/2017
Appendix D7 Company Survey Nonresponder Call Scrip 9_22t.docx	Appendix D7 Company Survey Nonresponder Call Script 9_22.docx	09/24/2017
Appendix D8 Store Survey Nonresponder Call Script 9_22.docx	Appendix D8 Store Survey Nonresponder Call Script 9_22.docx	09/24/2017
Appendix E Call Training Description.docx	Appendix E Call Training Description.docx	08/03/2017
Appendix F1 Company Pretest Instrument 9_22.docx	Appendix F1 Company Pretest Instrument 9_22.docx	09/24/2017
Appendix F2 Store Pretest Instrument 9_22	Appendix F2 Store Pretest Instrument 9_22.docx	09/24/2017

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