| Affected Public |
Respondent Description |
Type of Survey Instrument |
Appendices |
Sample size |
Estimated Sample Size and Respondent Burden |
| Responses |
Non-Responses |
Grand Total |
| Number of Respondents |
Frequency of Response (annual) |
Total Annual Responses |
Average Hours per Response |
Sub-Total Annual Burden |
Number of non -respondents |
Frequency of Response (annual) |
Total Annual Responses |
Average Hours per response |
Sub-Total Annual Burden |
Est. Grand Total Burden hours for respondents and non respondents |
Hourly Rate |
Total Annualized Cost |
| Household and Individuals |
SNAP participants |
Pretest for 2 SPS questions |
AO |
6 |
6 |
1 |
6 |
0.2500 |
1.5000 |
0 |
1 |
0 |
0.250 |
0 |
1.5000 |
7.25 |
10.88 |
| Pre-SPS Invitation Letter (a) |
D |
7,590 |
6,831 |
1 |
6,831 |
0.0501 |
342.2331 |
759 |
1 |
0 |
0.050 |
0 |
342.2331 |
7.25 |
2481.19 |
| Pre-SPS - Web(c) |
E |
6,831 |
1,025 |
1 |
1,025 |
0.3340 |
342.2331 |
5806 |
1 |
0 |
0.334 |
0 |
342.2331 |
7.25 |
2481.19 |
| SPS Reminder Postcard - 1 (b) |
F |
7,590 |
4,554 |
1 |
4,554 |
0.0167 |
76.0518 |
3036 |
1 |
0 |
0.017 |
0 |
76.0518 |
7.25 |
551.38 |
| Pre-SPS Reminder Letter 1 (d) |
G |
6,565 |
5,909 |
1 |
5,909 |
0.0167 |
98.6772 |
657 |
1 |
0 |
0.017 |
0 |
98.6772 |
7.25 |
715.41 |
| Pre-SPS Teleform - 1 (e) |
E |
5,909 |
2,068 |
1 |
2,068 |
0.3340 |
690.7405 |
3841 |
1 |
0 |
0.334 |
0 |
690.7405 |
7.25 |
5007.87 |
| SPS Reminder Postcard -2 (b) |
H |
6,565 |
3,939 |
1 |
3,939 |
0.0167 |
65.7848 |
2626 |
1 |
0 |
0.017 |
0 |
65.7848 |
7.25 |
476.94 |
| Pre-SPS Reminder Letter 2 (d) |
I |
4,497 |
4,048 |
1 |
4,048 |
0.0167 |
67.5939 |
450 |
1 |
0 |
0.017 |
0 |
67.5939 |
7.25 |
490.06 |
| Pre-SPS Teleform -2 (f) |
E |
4,048 |
1,012 |
1 |
1,012 |
0.3340 |
337.9694 |
3036 |
1 |
0 |
0.334 |
0 |
337.9694 |
7.25 |
2450.28 |
| Pre-SPS - Telephone Survey (g) |
J |
334 |
23 |
1 |
23 |
0.3340 |
7.8090 |
311 |
1 |
0 |
0.334 |
0 |
7.8090 |
7.25 |
56.62 |
| Voicemail Reminder for Telephone Survey (h) |
K |
334 |
200 |
1 |
200 |
0.0167 |
3.3467 |
134 |
1 |
0 |
0.017 |
0 |
3.3467 |
7.25 |
24.26 |
| Pre-SPS Thank You Letter (i) |
L |
4,128 |
4,128 |
1 |
4,128 |
0.0167 |
68.9376 |
0 |
1 |
0 |
0.017 |
0 |
68.9376 |
7.25 |
499.80 |
| Post-SPS Web Invitation letter (j) |
M |
4,128 |
3,715 |
1 |
3,715 |
0.0501 |
186.1315 |
413 |
1 |
0 |
0.050 |
0 |
186.1315 |
7.25 |
1349.45 |
| Post-SPS - Web (c) |
N,O |
3,715 |
669 |
1 |
669 |
0.3340 |
223.3578 |
3046 |
1 |
0 |
0.334 |
0 |
223.3578 |
7.25 |
1619.34 |
| SPS Reminder Postcard - 1 (b) |
F |
4,128 |
2,477 |
1 |
2,477 |
0.0167 |
41.3626 |
1651 |
1 |
0 |
0.017 |
0 |
41.3626 |
7.25 |
299.88 |
| Post-SPS Reminder Letter 1 (d) |
P |
3,459 |
3,113 |
1 |
3,113 |
0.0167 |
51.9927 |
346 |
1 |
0 |
0.017 |
0 |
51.9927 |
7.25 |
376.95 |
| Post-SPS Teleform - 1 (e) |
N,O |
3,113 |
1,090 |
1 |
1,090 |
0.3340 |
363.9492 |
2024 |
1 |
0 |
0.334 |
0 |
363.9492 |
7.25 |
2638.63 |
| SPS Reminder Postcard - 2 (b) |
H |
3,113 |
1,868 |
1 |
1,868 |
0.0167 |
31.1956 |
1245 |
1 |
0 |
0.017 |
0 |
31.1956 |
7.25 |
226.17 |
| Post-SPS Reminder Letter 2 (d) |
Q |
2,370 |
2,133 |
1 |
2,133 |
0.0167 |
35.6150 |
237 |
1 |
0 |
0.017 |
0 |
35.6150 |
7.25 |
258.21 |
| Post-SPS Teleform - 2 (f) |
N,O |
2,133 |
533 |
1 |
533 |
0.3340 |
178.0751 |
1599 |
1 |
0 |
0.334 |
0 |
178.0751 |
7.25 |
1291.04 |
| Post-SPS - Telephone Survey (g) |
J |
263 |
18 |
1 |
18 |
0.3340 |
6.1579 |
245 |
1 |
0 |
0.334 |
0 |
6.1579 |
7.25 |
44.64 |
| Voicemail Reminder for Telephone Survey (h) |
K |
263 |
158 |
1 |
158 |
0.0167 |
2.6391 |
105 |
1 |
105 |
0.017 |
1.75939519542857 |
4.3985 |
7.25 |
31.89 |
| Post-SPS Thank You Letter (i) |
R |
2,310 |
2,310 |
1 |
2,310 |
0.0167 |
38.5770 |
0 |
1 |
0 |
0.017 |
0 |
38.5770 |
7.25 |
279.68 |
| SNAP Participant KII Invitation Letter (k) |
S |
60 |
60 |
1 |
60 |
0.0167 |
1.0020 |
0 |
1 |
0 |
0.017 |
0 |
1.0020 |
7.25 |
7.26 |
| SNAP Participant KII Recruitment Script (l) |
T |
60 |
51 |
1 |
51 |
0.0835 |
4.2585 |
9 |
1 |
9 |
0.084 |
0.7515 |
5.0100 |
7.25 |
36.32 |
| SNAP participant KII Confirmation Letter (k) |
U |
51 |
51 |
1 |
51 |
0.0167 |
0.8517 |
0 |
1 |
0 |
0.017 |
0 |
0.8517 |
7.25 |
6.17 |
| SNAP Participant KII Discussion Guide (m) |
V |
51 |
41 |
1 |
41 |
1.0000 |
40.8000 |
10 |
1 |
10 |
1.000 |
10.2 |
51.0000 |
7.25 |
369.75 |
| SNAP participant KII Thank you Letter (i) |
W |
41 |
41 |
1 |
41 |
0.0167 |
0.6814 |
0 |
1 |
0 |
0.017 |
0 |
0.6814 |
7.25 |
4.94 |
| Individuals and Households Subtotal |
|
|
7,596 |
6,837 |
7.6160 |
52071 |
|
3309.5243 |
759 |
0.1641 |
125 |
|
12.7 |
3322.2351 |
|
24086.20 |
|
|
Submit SNAP administrative file |
- |
51 |
51 |
1 |
51 |
0.0250 |
1.2750 |
0 |
1 |
0 |
0.025 |
0 |
1.2750 |
53.15 |
67.77 |
| Request to complete Outlet Characteristics Form |
X |
5 |
5 |
1 |
5 |
0.0501 |
0.2505 |
0 |
1 |
0 |
0.050 |
0 |
0.2505 |
53.15 |
13.31 |
| Outlet Characteristics Form |
X |
5 |
5 |
1 |
5 |
1.0000 |
5.0000 |
0 |
1 |
0 |
1.000 |
0 |
5.0000 |
53.15 |
265.75 |
| Grantee Administrator Interview Scheduling (script), Year 1 (n) |
Y |
2 |
2 |
1 |
2 |
0.0835 |
0.1670 |
0 |
1 |
0 |
0.084 |
0 |
0.1670 |
53.15 |
8.88 |
| Grantee Administrator Interview Discussion Guide, Year 1 (o) |
Y |
2 |
2 |
1 |
2 |
1.5000 |
3.0000 |
0 |
1 |
0 |
1.500 |
0 |
3.0000 |
53.15 |
159.45 |
| Grantee Administrator Interview Thank you Postcard , Year 1(i) |
Z |
2 |
2 |
1 |
2 |
0.0167 |
0.0334 |
0 |
1 |
0 |
0.017 |
0 |
0.0334 |
53.15 |
1.78 |
| Quarterly Core Program Data Form Request Email, Year 1 (p) |
AB |
2 |
2 |
4 |
8 |
0.0167 |
0.1336 |
0 |
4 |
0 |
0.017 |
0 |
0.1336 |
53.15 |
7.10 |
| Annual Core Program Data Form Request Email , Year 1(p) |
AC |
2 |
2 |
1 |
2 |
0.0167 |
0.0334 |
0 |
1 |
0 |
0.017 |
0 |
0.0334 |
53.15 |
1.78 |
| Quarterly Core Program Data Form, Year 1 (q) |
AD |
2 |
2 |
4 |
8 |
0.3340 |
2.6720 |
0 |
4 |
0 |
0.334 |
0 |
2.6720 |
53.15 |
142.02 |
| Annual Core Program Data Form, Year 1 (q) |
AE |
2 |
2 |
1 |
2 |
0.2500 |
0.5000 |
0 |
1 |
0 |
0.250 |
0 |
0.5000 |
53.15 |
26.58 |
| Grantee Administrator Interview Scheduling (script), Year 2 (n) |
Y |
5 |
5 |
1 |
5 |
0.0835 |
0.4175 |
0 |
1 |
0 |
0.084 |
0 |
0.4175 |
53.15 |
22.19 |
| Grantee Administrator Interview Discussion Guide, Year 2 (o) |
Y |
5 |
5 |
1 |
5 |
1.5000 |
7.5000 |
0 |
1 |
0 |
1.500 |
0 |
7.5000 |
53.15 |
398.63 |
| Grantee Administrator Thank you Postcard, Year 2 (i) |
AA |
5 |
5 |
1 |
5 |
0.0167 |
0.0835 |
0 |
1 |
0 |
0.017 |
0 |
0.0835 |
53.15 |
4.44 |
| Quarterly Core Program Data Form Request Email, Year 2 (p) |
AB |
5 |
5 |
4 |
20 |
0.0167 |
0.3340 |
0 |
4 |
0 |
0.017 |
0 |
0.3340 |
53.15 |
17.75 |
| Annual Core Program Data Form Request Email, Year 2 (p) |
AC |
5 |
5 |
1 |
5 |
0.0167 |
0.0835 |
0 |
1 |
0 |
0.017 |
0 |
0.0835 |
53.15 |
4.44 |
| Quarterly Core Program Data Form, Year 2 (q) |
AD |
5 |
5 |
4 |
20 |
0.3340 |
6.6800 |
0 |
4 |
0 |
0.334 |
0 |
6.6800 |
53.15 |
355.04 |
| Annual Core Program Data Form, Year 2 (q) |
AE |
5 |
5 |
1 |
5 |
0.2500 |
1.2500 |
0 |
1 |
0 |
0.250 |
0 |
1.2500 |
53.15 |
66.44 |
| Quarterly Core Program Data Form Request Email, Year 3 (p) |
AB |
5 |
5 |
4 |
20 |
0.0167 |
0.3340 |
0 |
4 |
0 |
0.017 |
0 |
0.3340 |
53.15 |
17.75 |
| Annual Core Program Data Form Request Email, Year 3 (p) |
AC |
5 |
5 |
1 |
5 |
0.0167 |
0.0835 |
0 |
1 |
0 |
0.017 |
0 |
0.0835 |
53.15 |
4.44 |
| Quarterly Core Program Data Form, Year 3 (q) |
AD |
5 |
5 |
4 |
20 |
0.3340 |
6.6800 |
0 |
4 |
0 |
0.334 |
0 |
6.6800 |
53.15 |
355.04 |
| Annual Core Program Data Form, Year 3 (q) |
AE |
5 |
5 |
1 |
5 |
0.2500 |
1.2500 |
0 |
1 |
0 |
0.250 |
0 |
1.2500 |
53.15 |
66.44 |
| Email to Grantees for Followup with Nonresponding Outlets |
AI |
5 |
5 |
1 |
5 |
0.0501 |
0.2505 |
0 |
1 |
0 |
0.050 |
0 |
0.2505 |
53.15 |
13.31 |
| State/Local Government Subtotal (i) |
|
|
56 |
56 |
3.70 |
207 |
|
38.0114 |
0 |
0 |
0 |
|
0 |
38.0114 |
|
2020.31 |
| Profit/Non-Profit Business Subtotal |
Grantees and Administrators/ Retailers/Local Community Org. Staff |
Outlet Survey Cognitive Testing |
AP |
4 |
4 |
1 |
4 |
0.2500 |
1.0000 |
0 |
1 |
0 |
0.250 |
0 |
1.0000 |
53.15 |
53.15 |
| Email to accompany Outlet Characteristics Form |
X |
30 |
30 |
1 |
30 |
0.0501 |
1.5030 |
0 |
1 |
0 |
0.050 |
0 |
1.5030 |
53.15 |
79.88 |
| Outlet Characteristics Form |
X |
30 |
30 |
1 |
30 |
1.0000 |
30.0000 |
0 |
1 |
0 |
1.000 |
0 |
30.0000 |
53.15 |
1594.50 |
| Grantee Administrator Interview Scheduling (script), Year 1 (n) |
Y |
30 |
30 |
1 |
30 |
0.0835 |
2.5050 |
0 |
1 |
0 |
0.084 |
0 |
2.5050 |
53.15 |
133.14 |
| Grantee Administrator Interview Discussion Guide, Year 1 (o) |
Y |
30 |
30 |
1 |
30 |
1.5000 |
45.0000 |
0 |
1 |
0 |
1.500 |
0 |
45.0000 |
53.15 |
2391.75 |
| Grantee Administrator Interview Thank you Postcard , Year 1(i) |
Z |
30 |
30 |
1 |
30 |
0.0167 |
0.5010 |
0 |
1 |
0 |
0.017 |
0 |
0.5010 |
53.15 |
26.63 |
| Quarterly Core Program Data Form Request Email, Year 1 (p) |
AB |
30 |
30 |
4 |
120 |
0.0167 |
2.0040 |
0 |
4 |
0 |
0.017 |
0 |
2.0040 |
53.15 |
106.51 |
| Annual Core Program Data Form Request Email , Year 1(p) |
AC |
30 |
30 |
1 |
30 |
0.0167 |
0.5010 |
0 |
1 |
0 |
0.017 |
0 |
0.5010 |
53.15 |
26.63 |
| Quarterly Core Program Data Form, Year 1 (q) |
AD |
30 |
30 |
4 |
120 |
0.3340 |
40.0800 |
0 |
4 |
0 |
0.334 |
0 |
40.0800 |
53.15 |
2130.25 |
| Annual Core Program Data Form, Year 1 (q) |
AE |
30 |
30 |
1 |
30 |
0.2500 |
7.5000 |
0 |
1 |
0 |
0.250 |
0 |
7.5000 |
53.15 |
398.63 |
| Grantee Administrator Interview Scheduling (script), Year 2 (n) |
Y |
30 |
30 |
1 |
30 |
0.0835 |
2.5050 |
0 |
1 |
0 |
0.084 |
0 |
2.5050 |
53.15 |
133.14 |
| Grantee Administrator Interview Discussion Guide, Year 2 (o) |
Y |
30 |
30 |
1 |
30 |
1.5000 |
45.0000 |
0 |
1 |
0 |
1.500 |
0 |
45.0000 |
53.15 |
2391.75 |
| Grantee Administrator Thank you Postcard, Year 2 (i) |
AA |
30 |
30 |
1 |
30 |
0.0167 |
0.5010 |
0 |
1 |
0 |
0.017 |
0 |
0.5010 |
53.15 |
26.63 |
| Quarterly Core Program Data Form Request Email, Year 2 (p) |
AB |
30 |
30 |
4 |
120 |
0.0167 |
2.0040 |
0 |
4 |
0 |
0.017 |
0 |
2.0040 |
53.15 |
106.51 |
| Annual Core Program Data Form Request Email, Year 2 (p) |
AC |
30 |
30 |
1 |
30 |
0.0167 |
0.5010 |
0 |
1 |
0 |
0.017 |
0 |
0.5010 |
53.15 |
26.63 |
| Quarterly Core Program Data Form, Year 2 (q) |
AD |
30 |
30 |
4 |
120 |
0.3340 |
40.0800 |
0 |
4 |
0 |
0.334 |
0 |
40.0800 |
53.15 |
2130.25 |
| Annual Core Program Data Form, Year 2 (q) |
AE |
30 |
30 |
1 |
30 |
0.2500 |
7.5000 |
0 |
1 |
0 |
0.250 |
0 |
7.5000 |
53.15 |
398.63 |
| Quarterly Core Program Data Form Request Email, Year 3 (p) |
AB |
30 |
30 |
4 |
120 |
0.0167 |
2.0040 |
0 |
4 |
0 |
0.017 |
0 |
2.0040 |
53.15 |
106.51 |
| Annual Core Program Data Form Request Email, Year 3 (p) |
AC |
30 |
30 |
1 |
30 |
0.0167 |
0.5010 |
0 |
1 |
0 |
0.017 |
0 |
0.5010 |
53.15 |
26.63 |
| Quarterly Core Program Data Form, Year 3 (q) |
AD |
30 |
30 |
4 |
120 |
0.3340 |
40.0800 |
0 |
4 |
0 |
0.334 |
0 |
40.0800 |
53.15 |
2130.25 |
| Annual Core Program Data Form, Year 3 (q) |
AE |
30 |
30 |
1 |
30 |
0.2500 |
7.5000 |
0 |
1 |
0 |
0.250 |
0 |
7.5000 |
53.15 |
398.63 |
| Email to Grantees for Followup with Nonresponding Outlets |
AI |
30 |
30 |
1 |
30 |
0.0501 |
1.5030 |
0 |
1 |
0 |
0.050 |
0 |
1.5030 |
53.15 |
79.88 |
| Outlet Survey Invitation Letter (r) |
AF |
3600 |
3600 |
1 |
3600 |
0.0501 |
180.3600 |
0 |
1 |
0 |
0.050 |
0 |
180.3600 |
13.61 |
2454.70 |
| Outlet Survey Reminder Letter (s) |
AH |
1800 |
1710 |
1 |
1710 |
0.0167 |
28.5570 |
90 |
1 |
90 |
0.017 |
2 |
30.0600 |
13.61 |
409.12 |
| Outlet Survey (t) |
AG |
3600 |
2880 |
1 |
2880 |
0.1670 |
480.9600 |
720 |
1 |
720 |
0.167 |
120 |
601.2000 |
13.61 |
8182.33 |
| Outlet Survey Thank you Postcard (i) |
AJ |
2880 |
2880 |
1 |
2880 |
0.0167 |
48.0960 |
0 |
1 |
0 |
0.017 |
0 |
48.0960 |
13.61 |
654.59 |
| Profit/Non-Profit Business Subtotal |
|
|
3,634 |
2,914 |
4.2018 |
12244 |
|
1018.2460 |
720 |
1.125 |
810 |
|
121.74 |
1139.9890 |
|
26597.24 |
| GRAND TOTAL |
|
|
11,286 |
9,807 |
|
64,522 |
|
4365.7817 |
1479 |
|
935 |
|
134.45 |
4500.2355 |
|
52703.76 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| (a) Assume 90 percent of sampled participants will read the invitation letter - 5 percent postal nondeliverables and 5 percent not read |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| (b) Assume 60 percent of sampled participants will receive a reminder postcard |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| (c) Assume 15 percent of participants who read the invitation letter will complete the pre survey by web and 18 percent will complete the post survey by web |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| (d) Reminder letters will be sent to all non-respondents; assume 90 percent will read the letter - 5 percent postal nondeliverables and 5 percent not read |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| (e) Assume 35 percent of those who read the first reminder letter will complete the teleform survey |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| (f) Assume 25 percent of those who read the second reminder letter will complete the teleform survey |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| (g) Assume Non-respondents will be contacted by phone to achieve the targeted number of completes; assume 7 percent will complete the survey by phone |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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| (h) Non-respondents will be contacted by phone to achieve the targeted number of completes; messages will be left on voicemail for 60 percent with working phone numbers and voicemails |
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| (i) Thank you letters will be read by all respondents |
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| (j) Post-SPS invitation letters will be mailed to all those who completed the pre-SPS; 90 percent will read the invitation letter |
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| (k) Assume all SNAP participants will read the KII invitation letter and KII Confirmation Letter |
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| (l) Assume 85 percent of those contacted by phone will be scheduled for KII |
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| (m) Assume 80 percent of those who are scheduled for KII will participate in KII |
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| (n) Assume all grantees will be contacted to schedule KII |
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| (o) Assume all grantees will participate in KII |
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| (p) Assume all grantees will read the program data form request email |
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| (q) Assume all grantees will complete the program data forms. If grantees request to submit more than one respose on the annual form to accomdate subawardees or partner organizations, the agency will work with them on an individual basis. |
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| (r) Assume all outlet operators will read the invitation letter |
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| (s) Assume 50 percent of outlet operators will need a reminder letter and 95 percent of these will read it |
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| (t) Assume 80 percent of outlet operators will complete the outlet survey |
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| Annual Number of Respondents |
Annual Number of Respondents |
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3762 |
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NOTE: This is the sum of Number of respondents (H81 and M81) divided by 3 |
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| Total Annual Responses |
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21818.707919619 |
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NOTE: This is the sum of total annual responses (J81 and O81) divided by 3 |
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| Number of responses collected electronically, respondents: |
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2748.39 |
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NOTE: this includes respondent burden for pre-SPS, post-SPS, annual and quarterly CPD, and email to follow-up with outlets to complete outlet survey |
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| Number of responses collected electronically, nonrespondents: |
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0.00 |
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NOTE: this includes non- respondent burden for pre-SPS, post-SPS, annual and quarterly CPD, and email to follow-up with outlets to complete outlet survey |
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| % of responses collected electronically |
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4.36 |
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NOTE: this is the sum of respondent and non-respondent burden above |
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| TOTAL ANNUAL BURDEN |
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1500.07851559097 |
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NOTE: This is the total burden hours R81/3 |
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| % respondents that are small entities: |
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31.8979266347687 |
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NOTE: Assume only outlets are small entities (H78+M78)/(H81+M81)*100. |
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