Information Collection

Business Respondents: Grantees and Administrators/ Retailers/Local Community Org. Staff

IC 219871 under ICR 201811-0584-001 · OMB 0584-0616.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix AD.1. Quarterly Core Program Data Form - English only.docx	Other-Appendix AD.1. Quarterly Core
Appendix AD.2. Quarterly Core Program Data Web Form Screenshots - English only.docx www.notyetcreated.com	Other-Appendix AD.2. Quarterly Core
Appendix AE.1 Annual Core Program Data Form - English only.docx	Other-Appendix AE.1 Annual Core Prog
Appendix AE.2. Annual Core Program Data Web Form Screenshots - English only.docx www.notyetcreated.com	Other-Appendix AE.2. Annual Core Pro
Appendix AG.1. Outlet Survey Farmers Market - English only.docx	Other-Appendix AG.1. Outlet Survey F
Appendix AG.2. Outlet Survey Grocery Stores, CSAs, Farm Stands - English only.docx	Other-Appendix AG.2. Outlet Survey G
Appendix AP. Pretest protocol for Outlet Survey PRAO recommendations 2-1-16.docx	Other-Appendix AP. Pretest protocol
Appendix X.2. Outlet characteristics form.xlsx	Other-Appendix X.2. Outlet character
Appendix Y.2 Grantee Administrator Interview Discussion Guide - English only.docx	Other-Appendix Y.2 Grantee Administr
AG2. Revised grocery store survey Revised Clean.docx	Other-AG2. Revised 12-13-2018 grocer
AM. Telephone followup with nonresponding retailers Revised Clean.docx	Other-AM. Telephone Script to follow
Appendix AA. Grantee Administrator Post Intervention - Thank you card - English only.docx Appendix AA. Grantee Administrator Post Intervention - Thank you card - English only	IC Document
Appendix AB. Quarterly Core Program Data Form Email - English only.docx Appendix AB. Quarterly Core Program Data Form Email - English only	IC Document
Appendix AC. Annual Core Program Data Form Email - English only.docx Appendix AC. Annual Core Program Data Form Email - English only	IC Document
Appendix AF. Outlet Survey Invitation Letter - English only.docx Appendix AF. Outlet Survey Invitation Letter - English only	IC Document
Appendix AH. Outlet Survey Reminder Letter - English only.docx Appendix AH. Outlet Survey Reminder Letter - English only	IC Document
Appendix AI. Outlet Survey Email to Grantees - English only.docx Appendix AI. Outlet Survey Email to Grantees - English only	IC Document
Appendix AJ. Outlet Survey Thank you Letter - English only.docx Appendix AJ. Outlet Survey Thank you Letter - English only	IC Document
Appendix Y.1. Grantee Administrator Interview Scheduling Script - English only.docx Appendix Y.1. Grantee Administrator Interview Scheduling Script - English only	IC Document
Appendix X.1 Email to FINI grantees with outlet characteristic form.docx Appendix X.1 Email to FINI grantees with outlet characteristic form	IC Document
Appendix Z. Grantee Administrator Pre Intervention Thank you card - English only.docx Appendix Z. Grantee Administrator Pre Intervention Thank you card - English only	IC Document
AK. Second Survey Mailing Revised Clean.docx Added 12-13-2018 - Appendix AK. Second Survey Mailing Revised Clean.docx	IC Document
AL. Second Reminder Postcard Revised Clean.docx Added 12-13-2018 - Appendix AL. Second Reminder Postcard Revised Clean.docx	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Business Respondents: Grantees and Administrators/ Retailers/Local Community Org. Staff

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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 Y.2 Grantee Administrator Interview Discussion Guide - English only	Appendix Y.2 Grantee Administrator Interview Discussion Guide - English only.docx		No		Paper Only
Other-AM. Telephone Script to followup with nonresponding retailers Revised Clean 12-13-18.docx	AM. Telephone followup with nonresponding retailers Revised Clean.docx		No		Paper Only
Other-Appendix AD.1. Quarterly Core Program Data Form - English only	Appendix AD.1. Quarterly Core Program Data Form - English only.docx		No		Paper Only
Other-Appendix AD.2. Quarterly Core Program Data Web Form Screenshots - English only	Appendix AD.2. Quarterly Core Program Data Web Form Screenshots - English only.docx	www.notyetcreated.com	Yes	Yes	Paper Only
Other-Appendix AE.1 Annual Core Program Data Form - English only	Appendix AE.1 Annual Core Program Data Form - English only.docx		No		Paper Only
Other-Appendix AE.2. Annual Core Program Data Web Form Screenshots - English only	Appendix AE.2. Annual Core Program Data Web Form Screenshots - English only.docx	www.notyetcreated.com	Yes	Yes	Fillable Fileable Signable
Other-Appendix AG.1. Outlet Survey Farmers Market - English only	Appendix AG.1. Outlet Survey Farmers Market - English only.docx		No		Paper Only
Other-Appendix AG.2. Outlet Survey Grocery Stores, CSAs, Farm Stands - English only	Appendix AG.2. Outlet Survey Grocery Stores, CSAs, Farm Stands - English only.docx		No		Paper Only
Other-Appendix AP. Pretest protocol for Outlet Survey PRAO recommendations 2-1-16	Appendix AP. Pretest protocol for Outlet Survey PRAO recommendations 2-1-16.docx		No		Paper Only
Other-Appendix X.2. Outlet characteristics form	Appendix X.2. Outlet characteristics form.xlsx		No		Paper Only
Other-AG2. Revised 12-13-2018 grocery store survey Revised Clean.docx	AG2. Revised grocery store survey Revised Clean.docx		No		Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title: USDA/FNS 8 FNS Studies and Reports

FR Citation: 65 FR 17251

Number of Respondents: 3,499

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	16,959	4,715	12,244
Annual IC Time Burden (Hours)	1,455	437	1,018
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix AA. Grantee Administrator Post Intervention - Thank you card - English only	Appendix AA. Grantee Administrator Post Intervention - Thank you card - English only.docx	03/02/2016
Appendix AB. Quarterly Core Program Data Form Email - English only	Appendix AB. Quarterly Core Program Data Form Email - English only.docx	03/02/2016
Appendix AC. Annual Core Program Data Form Email - English only	Appendix AC. Annual Core Program Data Form Email - English only.docx	03/02/2016
Appendix AF. Outlet Survey Invitation Letter - English only	Appendix AF. Outlet Survey Invitation Letter - English only.docx	03/02/2016
Appendix AH. Outlet Survey Reminder Letter - English only	Appendix AH. Outlet Survey Reminder Letter - English only.docx	03/15/2016
Appendix AI. Outlet Survey Email to Grantees - English only	Appendix AI. Outlet Survey Email to Grantees - English only.docx	03/02/2016
Appendix AJ. Outlet Survey Thank you Letter - English only	Appendix AJ. Outlet Survey Thank you Letter - English only.docx	03/02/2016
Appendix Y.1. Grantee Administrator Interview Scheduling Script - English only	Appendix Y.1. Grantee Administrator Interview Scheduling Script - English only.docx	03/02/2016
Appendix X.1 Email to FINI grantees with outlet characteristic form	Appendix X.1 Email to FINI grantees with outlet characteristic form.docx	03/09/2016
Appendix Z. Grantee Administrator Pre Intervention Thank you card - English only	Appendix Z. Grantee Administrator Pre Intervention Thank you card - English only.docx	03/15/2016
Added 12-13-2018 - Appendix AK. Second Survey Mailing Revised Clean.docx	AK. Second Survey Mailing Revised Clean.docx	12/13/2018
Added 12-13-2018 - Appendix AL. Second Reminder Postcard Revised Clean.docx	AL. Second Reminder Postcard Revised Clean.docx	12/13/2018

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