Generic Clearance to Conduct Formative Research or Development of Nutrition Education and Promotion Materials and Related Tools and Grants for FNS Population Groups

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 9 Producer Final Survey	Form and Instruction	New	Available
Form 7 Recruitment	Form and Instruction	New	Repair queued
Form 6 Final Follow-up survey	Form and Instruction	New	Available
Form 4 Post-Training	Form and Instruction	New	Available
Form 3 Pre-Training Survey	Form and Instruction	New	Available
Form Informed Consent 2	Form and Instruction	New	Available
Form 1 1	Form	New	Available
Form FNS-814 FNS Visitor Form	Form	New	Available
Form FNS-854 Attendee Evaluation Form	Form	New	Available
Form FNS-817 Level 3 Event Feedback Form	Form	New	Available
Form FNS-816 Level 1 Event Feedback Form	Form	New	Available
Form FNS-814 FNS Visitor Form	Form	New	Available
Form FNS-854 Attendee Evaluation Form	Form	New	Available
Form FNS-817 Level 3 Event Feedback form	Form	New	Available
Form FNS-816 Level 1 Event Feedback Form	Form	New	Available
Form FNS-808 Power Panther Costume Event Feedback Form	Form	New	Available
Form FNS-807 Power Panther Costume Request and Agreement Form	Form	New	Available
Form FNS-781 Team Nutrition School Enrollment Form	Form	New	Available
0584-0524 Supporting Statement Part A for Generic Clearance Sept 30 2019.docx	Supporting Statement A	Uploaded 2019-09-30	Available
0584-0524 Supporting Statement Part B for Generic Clearance Sept 26 2019.docx	Supporting Statement B	Uploaded 2019-09-29	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
244770	Evaluation of the E-STAR Training Grant Program	Other-Appendix B_SNM Interview Protocol Year 1	New
242302	Evaluation of FY 2019 Summer Electronic Benefit Transfer (EBT) Demonstrations - Retailers (3 of 3)	Other-Attachment H Retailer Interview Protocol	New
242285	Evaluation of FY 2019 Summer Electronic Benefit Transfer (EBT) Demonstrations - Parents/Caregivers of Children (2 of 3)	Other-Attachment F.1 Focus Group Sign-In Sheet	New
242284	Evaluation of FY 2019 Summer Electronic Benefit Transfer (EBT) Demonstrations - State and Tribal Grantees and SFAs (1 of 3))	Other-Attachment B.1 Grantee Interview Protocol	New
240053	Evaluation of Farm to School Program Training and Curricula for State Agencies and Producers (Businesses/NGOs - 2 of 2)	Other-Trainer Informed Consent	New
239949	Evaluation of Farm to School Program Training and Curricula for State Agencies and Producers (S/L/T - 1 of 2)	Form and Instruction	New	Producer Final Survey
239949	Evaluation of Farm to School Program Training and Curricula for State Agencies and Producers (S/L/T - 1 of 2)	Form and Instruction	New	Recruitment
239949	Evaluation of Farm to School Program Training and Curricula for State Agencies and Producers (S/L/T - 1 of 2)	Form and Instruction	New	Final Follow-up survey
239949	Evaluation of Farm to School Program Training and Curricula for State Agencies and Producers (S/L/T - 1 of 2)	Form and Instruction	New	Post-Training
239949	Evaluation of Farm to School Program Training and Curricula for State Agencies and Producers (S/L/T - 1 of 2)	Form and Instruction	New	Pre-Training Survey
239949	Evaluation of Farm to School Program Training and Curricula for State Agencies and Producers (S/L/T - 1 of 2)	Form and Instruction	New	2
239949	Evaluation of Farm to School Program Training and Curricula for State Agencies and Producers (S/L/T - 1 of 2)	Form	New	1
239949	Evaluation of Farm to School Program Training and Curricula for State Agencies and Producers (S/L/T - 1 of 2)	Other-Trainer Informed Consent	New
237923	Collection of Produce Safety University Course Feedback and Program Impact Data - SLT	Other-Appendix A: PSU Welcome Questions	New
237922	Mealtimes with Toddlers in the Child and Adult Care Food Program - SLT	Other-Appendix F: Follow up Call to Screened Research Participan	New
237921	Improving School Meal Program Accuracy through Pre-Ordering and Grab and Go Systems - Students (Individuals and Households)	Other-Appendix E.1: Pre-ordering App Examples - Paper	New
237920	Improving School Meal Program Accuracy through Pre-ordering and Grab and Go Systems - SLT	Other-Appendix D.1: SFA/School Follow-up Script	New
237919	Team Nutrition Educational Technology Environmental Scan	Other-Appendix A: Consent Package for School Focus Groups	New
237918	Consumer Research for Nutrition Education and Promotion Activities - Business IC	Form	New	FNS Visitor Form
237918	Consumer Research for Nutrition Education and Promotion Activities - Business IC	Form	New	Attendee Evaluation Form
237918	Consumer Research for Nutrition Education and Promotion Activities - Business IC	Form	New	Level 3 Event Feedback Form
237918	Consumer Research for Nutrition Education and Promotion Activities - Business IC	Form	New	Level 1 Event Feedback Form
237917	Consumer Research for Nutrition Education and Promotion Activities -SLT IC	Form	New	FNS Visitor Form
237917	Consumer Research for Nutrition Education and Promotion Activities -SLT IC	Form	New	Attendee Evaluation Form
237917	Consumer Research for Nutrition Education and Promotion Activities -SLT IC	Form	New	Level 3 Event Feedback form
237917	Consumer Research for Nutrition Education and Promotion Activities -SLT IC	Form	New	Level 1 Event Feedback Form
237917	Consumer Research for Nutrition Education and Promotion Activities -SLT IC	Form	New	Power Panther Costume Event Feedback Form
237917	Consumer Research for Nutrition Education and Promotion Activities -SLT IC	Form	New	Power Panther Costume Request and Agreement Form
237917	Consumer Research for Nutrition Education and Promotion Activities -SLT IC	Form	New	Team Nutrition School Enrollment Form

ICR Details

OMB Control No: 0584-0524	ICR Reference No: 201906-0584-001
Status: Historical Active	Previous ICR Reference No: 201606-0584-008
Agency/Subagency: USDA/FNS	Agency Tracking No: Renewal 2019
Title: Generic Clearance to Conduct Formative Research or Development of Nutrition Education and Promotion Materials and Related Tools and Grants for FNS Population Groups
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/02/2019
Retrieve Notice of Action (NOA)	Date Received in OIRA: 09/30/2019
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2022	36 Months From Approved	11/30/2019
Responses	120,710	0	120,500
Time Burden (Hours)	46,823	0	46,781
Cost Burden (Dollars)	0	0	0

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Abstract: This information collection is necessary to obtain input into the development of nutrition education resources and interventions for population groups served by the Food and Nutrition Service (FNS). FNS will also use this information collection to obtain data that will be used to determine the scope and direction of various types of grants.

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Authorizing Statute(s): US Code: 42 USC 1754 (Section 5) Name of Law: Richard B. Russell National School Lunch Act
   US Code: 7 USC 2020 (Section 11(f)) Name of Law: Food and Nutrition Act of 2008
   PL: Pub.L. 109 - 85 19 Name of Law: Child Nutrition Act of 1966
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 65339	12/20/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 50373	09/25/2019
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 13

table that charts list of burden

IC Title	Form No.	Form Name
Collection of Produce Safety University Course Feedback and Program Impact Data - SLT
Consumer Research for Nutrition Education and Promotion Activities - Business IC	FNS-854, FNS-816, FNS-814, FNS-817	Level 1 Event Feedback Form ,   Level 3 Event Feedback Form ,   Attendee Evaluation Form ,   FNS Visitor Form
Consumer Research for Nutrition Education and Promotion Activities -SLT IC	FNS-808, FNS-817, FNS-781, FNS-854, FNS-814, FNS-807, FNS-816	Team Nutrition School Enrollment Form ,   Power Panther Costume Request and Agreement Form ,   Power Panther Costume Event Feedback Form ,   Level 1 Event Feedback Form ,   Level 3 Event Feedback form ,   Attendee Evaluation Form ,   FNS Visitor Form
Evaluation of FY 2019 Summer Electronic Benefit Transfer (EBT) Demonstrations - Parents/Caregivers of Children (2 of 3)
Evaluation of FY 2019 Summer Electronic Benefit Transfer (EBT) Demonstrations - Retailers (3 of 3)
Evaluation of FY 2019 Summer Electronic Benefit Transfer (EBT) Demonstrations - State and Tribal Grantees and SFAs (1 of 3))
Evaluation of Farm to School Program Training and Curricula for State Agencies and Producers (Businesses/NGOs - 2 of 2)
Evaluation of Farm to School Program Training and Curricula for State Agencies and Producers (S/L/T - 1 of 2)	Informed Consent, 3, 4, 6, 7, 9, 1	1 ,   2 ,   Pre-Training Survey ,   Post-Training ,   Final Follow-up survey ,   Recruitment ,   Producer Final Survey
Evaluation of the E-STAR Training Grant Program
Improving School Meal Program Accuracy through Pre-Ordering and Grab and Go Systems - Students (Individuals and Households)
Improving School Meal Program Accuracy through Pre-ordering and Grab and Go Systems - SLT
Mealtimes with Toddlers in the Child and Adult Care Food Program - SLT
Team Nutrition Educational Technology Environmental Scan

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	120,710	120,500	0	210	0	0
Annual Time Burden (Hours)	46,823	46,781	0	42	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a revision of a currently approved information collection with a three-year total burden of 46,781 burden hours and 120,500 responses. With this revision, FNS is adding a new form into the group of ongoing instruments approved under this clearance that are carried forward through the renewals. FNS estimates that this form will add 42 hours and 210 responses to the collection due to a program change. As a result of this revision, FNS estimates that the three-year total burden for this collection will be 46,823 hours and 120,710 responses.

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Annual Cost to Federal Government: $400,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 09/30/2019

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