Appendix 40.a Household Survey Door Hanger - English

Supporting Statement for OMB Clearance for the Study of Non-Response to the
School Meals Application Verification Process
Appendix 40a
Household Survey Door Hanger (English)

U.S. Department of
Agriculture (USDA)/Food and
Nutrition Service (FNS)
School Meal Application Study
SORRY WE MISSED YOU!
Mathematica’s Local Interviewer:

Phone Number:

Email Address:

Why is this study being done?
We’re conducting this study for the U.S. Department of Agriculture
to learn about households’ experiences with the school meals
application process and program.

Who is conducting the study?
Mathematica Policy Research is conducting the study for U.S.
Department of Agriculture (USDA)/Food and Nutrition Service
(FNS) School Meal Application Study

Will my answers be kept private?
All information gathered for the study is private to the full extent
allowed by law. The person who will interview you is prohibited
from sharing your personal information with anyone other than
authorized research staff. No information on households or
individual children will be reported. Your participation is entirely
voluntary.

How long will the interview take?
The interview usually takes about 45 minutes. And before the
interview, it may also take about 2 hours for you to locate
documentation we will ask you to provide. To thank you for
participating, you will receive a $25 VISA gift card.

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According to the Paperwork Reduction Act of 1995, an agency may not conduct or
sponsor, and a person is not required to respond to, a collection of information
unless it displays a valid OMB control number. The valid OMB control number
for this information collection is 0584-XXXX. The time required to complete
this information collection is estimated to average three minutes
per response, including the time for reviewing instructions,
searching existing data sources, gathering and maintaining
the data needed, and completing and reviewing
the collection of information.