Appendix 4 - 2021 Updates_Burden Table_SNAP-Ed Toolkit Intervention Submission Form Scoring Tool

Appendix 4 - 2021 Updates_Burden Table_SNAP-Ed Toolkit Intervention Submission Form Scoring Tool ks edits.xlsx

SNAP-Ed Toolkit Submission Form and Scoring Tool (FNS 885 and FNS 886) w/ Screenshots

Appendix 4 - 2021 Updates_Burden Table_SNAP-Ed Toolkit Intervention Submission Form Scoring Tool

OMB: 0584-0639

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Respondent Category Type of Respondents Instruments Form Number of Respondents Frequency of Response Total Annual Responses Hours per Response Annual Burden (Hours) Hourly Wage Rate Total Annualized Cost of Respondent Burden Fully Loaded Cost (x.33)
State/Local/Tribal Government SNAP-Ed State and Implementing Agency Dietitians & Nutritionists Intervention Submission Form FNS-886 13 1 13 6 78.0 $30.84 $2,405.52 $3,199.34
Intervention Submission Form (Training) FNS-886 13 1 13 1 13.0 $30.84 $400.92 $533.22
Scoring Tool FNS-885 9 2 18 2 36.0 $30.84 $1,110.24 $1,476.62
Scoring Tool (Training) FNS-885 9 1 9 1 9.0 $30.84 $277.56 $369.15
SUBTOTAL: State/Local/Tribal Government


44
53
136.0
$4,194.24 $5,578.34
Business, Non-Profit Biological Sciences Teachers, Postsecondary Intervention Submission Form FNS-886 29 1 29 6 174.0 $41.15 $7,160.10 $9,522.93
Intervention Submission Form (Pretesting) FNS-886 3 1 0 6 0.0 $41.15 $0.00 $0.00
Intervention Submission Form (Training) FNS-886 29 1 29 1 29.0 $41.15 $1,193.35 $1,587.16
Scoring Tool FNS-885 33 2 66 2 132.0 $41.15 $5,431.80 $7,224.29
Scoring Tool (Pretesting) FNS-885 3 1 0 2 0.0 $41.15 $0.00 $0.00
Scoring Tool (Training) FNS-885 33 1 33 1 33.0 $41.15 $1,357.95 $1,806.07
SUBTOTAL: Business, Non-Profit


130
157
368.0
$15,143.20 $20,140.46
Business, Profit Dietitians and Nutritionists Intervention Submission Form FNS-886 3 1 3 6 18.0 $30.84 $555.12 $738.31
Intervention Submission Form (Training) FNS-886 3 1 3 1 3.0 $30.84 $92.52 $123.05
Scoring Tool FNS-885 5 2 10 2 20.0 $30.84 $616.80 $820.34
Scoring Tool (Training) FNS-885 5 1 5 1 5.0 $30.84 $154.20 $205.09
SUBTOTAL: Business, Profit


16
21
46.0
$1,418.64 $1,886.79
TOTAL


190 1.2158 231 2.3810 550.0
$19,954.24 $27,605.59








































































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