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Attachment A: Burden Table |
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| Respondent Type |
Respondent Description |
Attachment |
Instrument |
Original Sample Size |
Responsive |
Non-Responsive |
Total Annual Estimated Burden Hours |
| Number of respondents |
Frequency of Responses |
Total Annual Responses |
Avg. Burden per Response (in hours) |
Annual Estimated Burden Hours |
Estimated number of non-respondents |
Frequency of Responses |
Total Annual non-Responses |
Avg. Burden per non-Response (in hours) |
Annual Estimated Burden Hours |
| State, Local, or Tribal Governments |
State and Tribal Grantees |
B.1 |
Grantee Interview Protocol |
4 |
4 |
0.75 |
3.00 |
1.5 |
4.50 |
0 |
0 |
0 |
0 |
0 |
4.50 |
| B.2 |
Shortened Grantee Interview Protocol |
1 |
1 |
0.33 |
0.33 |
0.5 |
0.17 |
0 |
0 |
0 |
0 |
0 |
0.17 |
| C.1 |
Study Team Introductory Email to Grantees |
4 |
4 |
0.75 |
3.00 |
2.00 |
6.00 |
0 |
0 |
0 |
0 |
0 |
6.00 |
| C.2 |
Interview Confirmation Email Template for Grantees |
4 |
4 |
0.75 |
3.00 |
0.02 |
0.05 |
0 |
0 |
0 |
0 |
0 |
0.05 |
| Subtotal for state and tribal grantees |
4 |
4 |
2.33 |
9.33 |
1.15 |
10.72 |
0 |
0 |
0 |
0 |
0 |
10.72 |
| School Food Authorities (SFAs) |
D |
SFA Interview Protocol |
8 |
8 |
0.75 |
6.00 |
1 |
6.00 |
0 |
0 |
0 |
0 |
0 |
6.00 |
| E.1 |
Grantee Introductory Email to SFAs |
8 |
8 |
0.75 |
6.00 |
0.02 |
0.10 |
0 |
0 |
0 |
0 |
0 |
0.10 |
| E.2 |
Study Team Introductory Email to SFAs |
8 |
8 |
0.75 |
6.00 |
9.00 |
54.00 |
0 |
0 |
0 |
0 |
0 |
54.00 |
| E.3 |
Recruitment FAQ Sheet for SFAs |
8 |
8 |
0.75 |
6.00 |
0.02 |
0.10 |
0 |
0 |
0 |
0 |
0 |
0.10 |
| E.4 |
Study Overview Sheet for SFAs |
8 |
8 |
0.75 |
6.00 |
0.02 |
0.10 |
0 |
0 |
0 |
0 |
0 |
0.10 |
| E.5 |
Telephone Script for SFA Recruitment |
8 |
8 |
0.75 |
6.00 |
0.08 |
0.50 |
0 |
0 |
0 |
0 |
0 |
0.50 |
| E.6 |
Interview Confirmation Email Template for SFAs |
8 |
8 |
0.75 |
6.00 |
0.02 |
0.10 |
0 |
0 |
0 |
0 |
0 |
0.10 |
| Subtotal for SFAs |
8 |
8 |
5.25 |
42.0 |
1.45 |
60.9 |
0 |
0 |
0 |
0 |
0 |
60.9 |
| Subtotal of all state, local, tribal governments |
12 |
12 |
4.28 |
51.33 |
1.40 |
71.62 |
0 |
0 |
0 |
0 |
0 |
71.62 |
| Individuals |
Parents/caregivers of Children in Program |
F.1 |
Focus Group Sign-In Sheet |
160 |
160 |
0.75 |
120.0 |
0.05 |
6.0 |
0 |
0 |
0 |
0 |
0 |
6.0 |
| F.2 |
Focus Group Consent Form |
160 |
160 |
0.75 |
120.0 |
0.08 |
10.0 |
0 |
0 |
0 |
0 |
0 |
10.0 |
| F.3 |
Parent/Caregiver Focus Group Interview Protocol |
160 |
160 |
0.75 |
120.0 |
1.00 |
120.0 |
0 |
0 |
0 |
0 |
0 |
120.0 |
| G.1 |
Recruitment Flyer/Handout for Focus Group |
480 |
160 |
0.75 |
120.0 |
0.02 |
2.0 |
320 |
0.75 |
240 |
0.02 |
4.00 |
6.0 |
| G.2 |
Recruitment FAQ Sheet for Focus Groups |
480 |
160 |
0.75 |
120.0 |
0.02 |
2.0 |
320 |
0.75 |
240 |
0.02 |
4.00 |
6.0 |
| G.3 |
Study Overview Sheet for Focus Group Participants |
480 |
160 |
0.75 |
120.0 |
0.02 |
2.0 |
320 |
0.75 |
240 |
0.02 |
4.00 |
6.0 |
| G.4 |
Telephone Script for Focus Group Confirmation |
160 |
160 |
0.75 |
120.0 |
0.08 |
10.0 |
0 |
0 |
0 |
0.00 |
0.00 |
10.0 |
| G.5 |
Focus Group Confirmation Email Template for Focus Group Participants |
160 |
160 |
0.75 |
120.0 |
0.02 |
2.0 |
0 |
0 |
0 |
0.00 |
0.00 |
2.0 |
| Subtotals for Individuals/Households |
480 |
160 |
6.00 |
960.00 |
0.16 |
154.00 |
320 |
2.25 |
720.0 |
0.02 |
12.00 |
166.0 |
| Businesses or Other for Profit |
Retailers Who Participate in Program |
H |
Retailer interview protocol |
20 |
20 |
0.75 |
15.0 |
0.5 |
8.00 |
0 |
0 |
0 |
0 |
0 |
8.00 |
| I.1 |
Grantee introductory email to retailers |
32 |
20 |
0.75 |
15.0 |
0.02 |
0.25 |
12 |
0.75 |
9 |
0.02 |
0.15 |
0.40 |
| I.2 |
Study team introductory email to retailers |
32 |
20 |
0.75 |
15.0 |
0.02 |
0.25 |
12 |
0.75 |
9 |
0.02 |
0.15 |
0.40 |
| 1.3 |
Telephone Script For Retailer Recruitment |
32 |
20 |
0.75 |
15.0 |
0.08 |
1.25 |
12 |
0.75 |
9 |
0.08 |
0.75 |
2.00 |
| I.4 |
Interview Confirmation Email Template for Retailer |
20 |
20 |
0.75 |
15.0 |
0.02 |
0.25 |
0 |
0 |
0 |
0.00 |
0.00 |
0.25 |
| Subtotals for Businesses |
32 |
20 |
3.75 |
75.0 |
0.13 |
10.00 |
12 |
2.25 |
27.0 |
0.04 |
1.05 |
11.05 |
| Total Reporting Burden |
524 |
192 |
5.66 |
1086.33 |
0.22 |
235.62 |
332 |
2.25 |
747.00 |
0.02 |
13.05 |
248.67 |
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