Information Collection

Business Respondents

IC 247758 under ICR 202105-0584-001 · OMB 0584-0669.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0669 can be found here:

2022-10-17 - No material or nonsubstantive change to a currently approved collection
2022-05-02 - No material or nonsubstantive change to a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
C5_Study FAQs.docx	Other-C5_Study FAQs.
C5_Study FAQs.docx	Other-C5_Study FAQs.
C6_Study FAQs - Spanish.docx	Other-C6_Study FAQs - Spanish
C6_Study FAQs - Spanish.docx	Other-C6_Study FAQs - Spanish
C7_USDA Endorsement Letter.docx	Other-C7_USDA Endorsement Letter
C7_USDA Endorsement Letter.docx	Other-C7_USDA Endorsement Letter
C8_USDA Endorsement Letter - Spanish.docx	Other-C8_USDA Endorsement Letter - S
C8_USDA Endorsement Letter - Spanish.docx	Other-C8_USDA Endorsement Letter - S
C9_Generic Endorsement Letter.docx	Other-C9_Generic Endorsement Letter
C9_Generic Endorsement Letter.docx	Other-C9_Generic Endorsement Letter
C10_Generic Endorsement Letter - Spanish.docx	Other-C10_Generic Endorsement Letter
C10_Generic Endorsement Letter - Spanish.docx	Other-C10_Generic Endorsement Letter
C11_Sponsor Recruitment Letter.docx	Other-C11_Sponsor Recruitment Letter
C11_Sponsor Recruitment Letter.docx	Other-C11_Sponsor Recruitment Letter
C12_Sponsor Recruitment Follow-Up Email.docx	Other-C12_Sponsor Recruitment Follow
C12_Sponsor Recruitment Follow-Up Email.docx	Other-C12_Sponsor Recruitment Follow
C13_Sponsor Recruitment Call Script.docx	Other-C13_Sponsor Recruitment Call S
C13_Sponsor Recruitment Call Script.docx	Other-C13_Sponsor Recruitment Call S
C14_Sponsor Enrollment Confirmation Email.docx	Other-C14_Sponsor Enrollment Confirm
C14_Sponsor Enrollment Confirmation Email.docx	Other-C14_Sponsor Enrollment Confirm
C15_Endorsement Email to Encourage Provider Participation.docx	Other-C15_Endorsement Email to Encou
C15_Endorsement Email to Encourage Provider Participation.docx	Other-C15_Endorsement Email to Encou
C16_Endorsement Email to Encourage Provider Participation - Spanish.docx	Other-C16_Endorsement Email to Encou
C16_Endorsement Email to Encourage Provider Participation - Spanish.docx	Other-C16_Endorsement Email to Encou
C17_Study Brochure.pdf	Other-C17_Study Brochure
C17_Study Brochure.pdf	Other-C17_Study Brochure
C18_Study Brochure - Spanish.pdf	Other-C18_Study Brochure - Spanish
C18_Study Brochure - Spanish.pdf	Other-C18_Study Brochure - Spanish
D1_Recruitment Website_6.11.21.pdf	Other-D1_Recruitment Website
D1_Recruitment Website_6.11.21.pdf	Other-D1_Recruitment Website
D2_Recruitment Website - Spanish_6.11.21.pdf	Other-D2_Recruitment Website - Spani
D2_Recruitment Website - Spanish_6.11.21.pdf	Other-D2_Recruitment Website - Spani
C19_Provider Recruitment Letter.docx	Other-C19_Provider Recruitment Lette
C19_Provider Recruitment Letter.docx	Other-C19_Provider Recruitment Lette
C20_Provider Recruitment Letter - Spanish.docx	Other-C20_Provider Recruitment Lette
C20_Provider Recruitment Letter - Spanish.docx	Other-C20_Provider Recruitment Lette
C21_Provider Recruitment Follow-up Email.docx	Other-C21_Provider Recruitment Follo
C21_Provider Recruitment Follow-up Email.docx	Other-C21_Provider Recruitment Follo
C22_Provider Recruitment Follow-up Email - Spanish.docx	Other-C22_Provider Recruitment Follo
C22_Provider Recruitment Follow-up Email - Spanish.docx	Other-C22_Provider Recruitment Follo
C23_Provider Recruitment Call Script.docx	Other-C23_Provider Recruitment Call
C23_Provider Recruitment Call Script.docx	Other-C23_Provider Recruitment Call
C24_Provider Recruitment Call Script - Spanish.docx	Other-C24_Provider Recruitment Call
C24_Provider Recruitment Call Script - Spanish.docx	Other-C24_Provider Recruitment Call
C25_Provider Post-Recruitment Incentive Letter.docx	Other-C25_Provider Post-Recruitment
C25_Provider Post-Recruitment Incentive Letter.docx	Other-C25_Provider Post-Recruitment
C26_Provider Post-Recruitment Incentive Letter - Spanish.docx	Other-C26_Provider Post-Recruitment
C26_Provider Post-Recruitment Incentive Letter - Spanish.docx	Other-C26_Provider Post-Recruitment
C27_Pre-Visit Planning Interview Script.docx	Other-C27_Pre-Visit Planning Intervi
C27_Pre-Visit Planning Interview Script.docx	Other-C27_Pre-Visit Planning Intervi
C28 Pre-Visit Planning Interview Script - Spanish.docx	Other-C28 Pre-Visit Planning Intervi
C28 Pre-Visit Planning Interview Script - Spanish.docx	Other-C28 Pre-Visit Planning Intervi
C29_Provider Enrollment Confirmation Email.docx	Other-C29_Provider Enrollment Confir
C29_Provider Enrollment Confirmation Email.docx	Other-C29_Provider Enrollment Confir
C30 Provider Enrollment Confirmation Email - Spanish_052421.docx	Other-C30 Provider Enrollment Confir
C30 Provider Enrollment Confirmation Email - Spanish_052421.docx	Other-C30 Provider Enrollment Confir
F1_Provider Survey Invitation Email.docx	Other-F1_Provider Survey Invitation
F1_Provider Survey Invitation Email.docx	Other-F1_Provider Survey Invitation
F2_Provider Survey Invitation Email - Spanish.docx	Other-F2_Provider Survey Invitation
F2_Provider Survey Invitation Email - Spanish.docx	Other-F2_Provider Survey Invitation
F3_Provider Survey Reminder Email.docx	Other-F3_Provider Survey Reminder Em
F3_Provider Survey Reminder Email.docx	Other-F3_Provider Survey Reminder Em
F4_Provider Survey Reminder Email - Spanish.docx	Other-F4_Provider Survey Reminder Em
F4_Provider Survey Reminder Email - Spanish.docx	Other-F4_Provider Survey Reminder Em
F5_Provider Survey Reminder Call Script.docx	Other-F5_Provider Survey Reminder Ca
F5_Provider Survey Reminder Call Script.docx	Other-F5_Provider Survey Reminder Ca
F6_Provider Survey Reminder Call Script - Spanish.docx	Other-F6_Provider Survey Reminder Ca
F6_Provider Survey Reminder Call Script - Spanish.docx	Other-F6_Provider Survey Reminder Ca
F7_Provider Survey.docx	Other-F7_Provider Survey
F7_Provider Survey.docx	Other-F7_Provider Survey
F8_Provider Survey - Spanish.docx	Other-F8_Provider Survey - Spanish
F8_Provider Survey - Spanish.docx	Other-F8_Provider Survey - Spanish
F11_Menu Survey.docx	Other-F11_Menu Survey
F11_Menu Survey.docx	Other-F11_Menu Survey
F12_Menu Survey - Spanish.docx	Other-F12_Menu Survey - Spanish
F12_Menu Survey - Spanish.docx	Other-F12_Menu Survey - Spanish
F13_Food Description Guide.docx	Other-F13_Food Description Guide
F13_Food Description Guide.docx	Other-F13_Food Description Guide
F14_Food Description Guide - Spanish.docx	Other-F14_Food Description Guide - S
F14_Food Description Guide - Spanish.docx	Other-F14_Food Description Guide - S
F15_Infant Menu Survey.docx	Other-F15_Infant Menu Survey
F15_Infant Menu Survey.docx	Other-F15_Infant Menu Survey
F16_Infant Menu Survey - Spanish.docx	Other-F16_Infant Menu Survey - Spani
F16_Infant Menu Survey - Spanish.docx	Other-F16_Infant Menu Survey - Spani
F17_Infant Intake Form.docx	Other-F17_Infant Intake Form
F17_Infant Intake Form.docx	Other-F17_Infant Intake Form
F18_Infant Intake Form - Spanish.docx	Other-F18_Infant Intake Form - Spani
F18_Infant Intake Form - Spanish.docx	Other-F18_Infant Intake Form - Spani
F20_Meal Observation Booklet.docx	Other-F20_Meal Observation Booklet
F20_Meal Observation Booklet.docx	Other-F20_Meal Observation Booklet
E1_Pre-Visit Cost Telephone Interview.docx	Other-E1_Pre-Visit Cost Telephone In
E1_Pre-Visit Cost Telephone Interview.docx	Other-E1_Pre-Visit Cost Telephone In
E2_Pre-Visit Cost Form.docx	Other-E2_Pre-Visit Cost Form
E2_Pre-Visit Cost Form.docx	Other-E2_Pre-Visit Cost Form
E3_Self-Administered Cost Questionnaire.docx	Other-E3_Self-Administered Cost Ques
E3_Self-Administered Cost Questionnaire.docx	Other-E3_Self-Administered Cost Ques
E4_Sponsor-Center Cost Interview.docx	Other-E4_Sponsor-Center Cost Intervi
E4_Sponsor-Center Cost Interview.docx	Other-E4_Sponsor-Center Cost Intervi
E5_Center Director Cost Interview.docx	Other-E5_Center Director Cost Interv
E5_Center Director Cost Interview.docx	Other-E5_Center Director Cost Interv
E6_Center Food Service Cost Interview.docx	Other-E6_Center Food Service Cost In
E6_Center Food Service Cost Interview.docx	Other-E6_Center Food Service Cost In
C31_Onsite Point-of-Contact Letter.docx	Other-C31_Onsite Point-of-Contact Le
C31_Onsite Point-of-Contact Letter.docx	Other-C31_Onsite Point-of-Contact Le
C32_Onsite Point-of-Contact Letter - Spanish.docx	Other-C32_Onsite Point-of-Contact Le
C32_Onsite Point-of-Contact Letter - Spanish.docx	Other-C32_Onsite Point-of-Contact Le
F9_Provider Survey Screenshots.docx	Other-F9_Provider Survey Screenshots
F9_Provider Survey Screenshots.docx	Other-F9_Provider Survey Screenshots
F10_Provider Survey Screenshots - Spanish.docx	Other-F10_Provider Survey Screenshot
F10_Provider Survey Screenshots - Spanish.docx	Other-F10_Provider Survey Screenshot
F19_Environmental Observation Form_7.20.21.docx F19_Environmental Observation Form	IC Document
F19_Environmental Observation Form_7.20.21.docx F19_Environmental Observation Form	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Business Respondents

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-C5_Study FAQs.	C5_Study FAQs.docx	No		Paper Only
Other-C6_Study FAQs - Spanish	C6_Study FAQs - Spanish.docx	No		Paper Only
Other-C7_USDA Endorsement Letter	C7_USDA Endorsement Letter.docx	No		Paper Only
Other-C8_USDA Endorsement Letter - Spanish	C8_USDA Endorsement Letter - Spanish.docx	No		Paper Only
Other-C9_Generic Endorsement Letter	C9_Generic Endorsement Letter.docx	No		Paper Only
Other-C10_Generic Endorsement Letter - Spanish	C10_Generic Endorsement Letter - Spanish.docx	No		Paper Only
Other-C11_Sponsor Recruitment Letter	C11_Sponsor Recruitment Letter.docx	No		Paper Only
Other-C12_Sponsor Recruitment Follow-Up Email	C12_Sponsor Recruitment Follow-Up Email.docx	Yes	No	Printable Only
Other-C13_Sponsor Recruitment Call Script	C13_Sponsor Recruitment Call Script.docx	No		Paper Only
Other-C14_Sponsor Enrollment Confirmation Email	C14_Sponsor Enrollment Confirmation Email.docx	Yes	No	Printable Only
Other-C15_Endorsement Email to Encourage Provider Participation	C15_Endorsement Email to Encourage Provider Participation.docx	Yes	No	Printable Only
Other-C16_Endorsement Email to Encourage Provider Participation - Spanish	C16_Endorsement Email to Encourage Provider Participation - Spanish.docx	Yes	No	Printable Only
Other-C17_Study Brochure	C17_Study Brochure.pdf	No		Paper Only
Other-C18_Study Brochure - Spanish	C18_Study Brochure - Spanish.pdf	No		Paper Only
Other-D1_Recruitment Website	D1_Recruitment Website_6.11.21.pdf	Yes	Yes	Fillable Printable
Other-D2_Recruitment Website - Spanish_	D2_Recruitment Website - Spanish_6.11.21.pdf	Yes	Yes	Fillable Printable
Other-C19_Provider Recruitment Letter	C19_Provider Recruitment Letter.docx	No		Paper Only
Other-C20_Provider Recruitment Letter - Spanish	C20_Provider Recruitment Letter - Spanish.docx	No		Paper Only
Other-C21_Provider Recruitment Follow-up Email	C21_Provider Recruitment Follow-up Email.docx	Yes	No	Printable Only
Other-C22_Provider Recruitment Follow-up Email - Spanish	C22_Provider Recruitment Follow-up Email - Spanish.docx	Yes	No	Printable Only
Other-C23_Provider Recruitment Call Script	C23_Provider Recruitment Call Script.docx	No		Paper Only
Other-C24_Provider Recruitment Call Script - Spanish	C24_Provider Recruitment Call Script - Spanish.docx	No		Paper Only
Other-C25_Provider Post-Recruitment Incentive Letter	C25_Provider Post-Recruitment Incentive Letter.docx	No		Paper Only
Other-C26_Provider Post-Recruitment Incentive Letter - Spanish	C26_Provider Post-Recruitment Incentive Letter - Spanish.docx	No		Paper Only
Other-C27_Pre-Visit Planning Interview Script	C27_Pre-Visit Planning Interview Script.docx	No		Paper Only
Other-C28 Pre-Visit Planning Interview Script - Spanish	C28 Pre-Visit Planning Interview Script - Spanish.docx	No		Paper Only
Other-C29_Provider Enrollment Confirmation Email	C29_Provider Enrollment Confirmation Email.docx	Yes	No	Printable Only
Other-C30 Provider Enrollment Confirmation Email - Spanish_052421	C30 Provider Enrollment Confirmation Email - Spanish_052421.docx	Yes	No	Printable Only
Other-F1_Provider Survey Invitation Email	F1_Provider Survey Invitation Email.docx	Yes	No	Printable Only
Other-F2_Provider Survey Invitation Email - Spanish	F2_Provider Survey Invitation Email - Spanish.docx	Yes	No	Printable Only
Other-F3_Provider Survey Reminder Email	F3_Provider Survey Reminder Email.docx	Yes	No	Printable Only
Other-F4_Provider Survey Reminder Email - Spanish	F4_Provider Survey Reminder Email - Spanish.docx	Yes	No	Printable Only
Other-F5_Provider Survey Reminder Call Script	F5_Provider Survey Reminder Call Script.docx	No		Paper Only
Other-F6_Provider Survey Reminder Call Script - Spanish	F6_Provider Survey Reminder Call Script - Spanish.docx	No		Paper Only
Other-F7_Provider Survey	F7_Provider Survey.docx	No		Paper Only
Other-F8_Provider Survey - Spanish	F8_Provider Survey - Spanish.docx	No		Paper Only
Other-F11_Menu Survey	F11_Menu Survey.docx	No		Paper Only
Other-F12_Menu Survey - Spanish	F12_Menu Survey - Spanish.docx	No		Paper Only
Other-F13_Food Description Guide	F13_Food Description Guide.docx	No		Paper Only
Other-F14_Food Description Guide - Spanish	F14_Food Description Guide - Spanish.docx	No		Paper Only
Other-F15_Infant Menu Survey	F15_Infant Menu Survey.docx	No		Paper Only
Other-F16_Infant Menu Survey - Spanish	F16_Infant Menu Survey - Spanish.docx	No		Paper Only
Other-F17_Infant Intake Form	F17_Infant Intake Form.docx	No		Paper Only
Other-F18_Infant Intake Form - Spanish	F18_Infant Intake Form - Spanish.docx	No		Paper Only
Other-F20_Meal Observation Booklet	F20_Meal Observation Booklet.docx	No		Paper Only
Other-E1_Pre-Visit Cost Telephone Interview	E1_Pre-Visit Cost Telephone Interview.docx	No		Paper Only
Other-E2_Pre-Visit Cost Form	E2_Pre-Visit Cost Form.docx	No		Paper Only
Other-E3_Self-Administered Cost Questionnaire	E3_Self-Administered Cost Questionnaire.docx	No		Paper Only
Other-E4_Sponsor-Center Cost Interview	E4_Sponsor-Center Cost Interview.docx	No		Paper Only
Other-E5_Center Director Cost Interview	E5_Center Director Cost Interview.docx	No		Paper Only
Other-E6_Center Food Service Cost Interview	E6_Center Food Service Cost Interview.docx	No		Paper Only
Other-C31_Onsite Point-of-Contact Letter	C31_Onsite Point-of-Contact Letter.docx	No		Paper Only
Other-C32_Onsite Point-of-Contact Letter - Spanish	C32_Onsite Point-of-Contact Letter - Spanish.docx	No		Paper Only
Other-F9_Provider Survey Screenshots	F9_Provider Survey Screenshots.docx	Yes	Yes	Fillable Fileable
Other-F10_Provider Survey Screenshots - Spanish	F10_Provider Survey Screenshots - Spanish.docx	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title: FNS-8 USDA/FNS Studies and Reports

FR Citation: 56 FR 19078

Number of Respondents: 4,781

Number of Respondents for Small Entity: 35

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 19 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	12,108	12,108
Annual IC Time Burden (Hours)	15,467	15,467
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
F19_Environmental Observation Form	F19_Environmental Observation Form_7.20.21.docx	07/20/2021

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