| INSTRUCTIONS |
| We would like you to list all FINI outlets that your organization operated in 2015 and projections for 2016 and 2017 on the next tab titled "outlet level dataform." We asking you to provide the following information for each outlet: |
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| Variable |
Explanation |
Response Options |
| FNS Authorization Number |
FNS Authorization Number assigned to that outlet. This should be unique per outlet. |
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| Outlet Name |
Outlet Name |
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| Outlet Address Number |
Location of the outlet, which we will use to map all FINI outlets in a state. |
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| Outlet Street |
| Outlet City |
| Outlet State Code |
| Outlet Zip |
| Outlet Zip4 |
| Outlet Type |
Outlet Type |
Large Chain Grocery Store/Supermarket |
| Discount Superstore |
| Convenience Store |
| Small Store or Corner Store |
| Farmers Market |
| Direct Farm |
| Farm Stand |
| Mobile market at single location |
| Mobile market at multiple locations |
| CSA |
| Incentive Match Rate |
Incentive Match Rate |
a = <1:1 |
| b = 1:1 |
| c = >1:1 |
| d = a and b above |
| e = a and c above |
| f = b and c above |
| g = all of the above |
| Incentive Offered in 2015? |
Incentive was offered in 2015? |
Yes; No; Don't Know |
| Incentive offered in 2016? |
Will this outlet offer FINI incentive in 2016? Please make an attempt to predict what will happen in 2016 if you are still planning. |
Yes; No; Don't Know |
| Incentive offered in 2017? |
Will this outlet offer FINI Incentive in 2017? Please make an attempt to predict what will happen in 2017. |
Yes; No; Don't Know |
| Open year round in 2017? |
Open year round in 2017? |
Yes; No; Don't Know |
| Incentive offered February 2017? |
Incentive offered February 2017? |
Yes; No; Don't Know |
| Incentive offered March 2017? |
Incentive offered March 2017? |
Yes; No; Don't Know |
| Incentive offered April 2017? |
Incentive offered April 2017? |
Yes; No; Don't Know |
| Incentive offered May 2017? |
Incentive offered May 2017? |
Yes; No; Don't Know |
| Incentive offered June 2017? |
Incentive offered June 2017? |
Yes; No; Don't Know |
| Incentive offered July 2017? |
Incentive offered July 2017? |
Yes; No; Don't Know |
| Incentive offered August 2017? |
Incentive offered August 2017? |
Yes; No; Don't Know |
| Incentive offered September 2017? |
Incentive offered September 2017? |
Yes; No; Don't Know |
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| According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB number. The time required to complete this information collection is estimated to average 60 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. |
| FNS Authorization Number |
Outlet Name |
Outlet Address Number |
Outlet Street |
Outlet City |
Outlet State Code |
Outlet Zip |
Outlet Zip4 |
Outlet Type |
Incentive Match rate |
Incentive Offered in 2015? |
Incentive offered in 2016? |
Incentive offered in 2017? |
Open year round in 2017? |
Incentive offered February 2017? |
Incentive offered March 2017? |
Incentive offered April 2017? |
Incentive offered May 2017? |
Incentive offered June 2017? |
Incentive offered July 2017? |
Incentive offered August 2017? |
Incentive offered September 2017? |