Information Collection

Business Respondents

IC 247758 under ICR 202204-0584-006 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
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
C12_Sponsor Recruitment Follow-Up Email.docx	Other-C12_Sponsor Recruitment Follow
C12_Sponsor Recruitment Follow-Up Email.docx	Other-C12_Sponsor Recruitment Follow
C14_Sponsor Enrollment Confirmation Email.docx	Other-C14_Sponsor Enrollment Confirm
C14_Sponsor Enrollment Confirmation Email.docx	Other-C14_Sponsor Enrollment Confirm
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
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
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
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
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
E3_Self-Administered Cost Questionnaire.docx	Other-E3_Self-Administered Cost Ques
E3_Self-Administered Cost Questionnaire.docx	Other-E3_Self-Administered Cost Ques
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
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
C11_Sponsor Recruitment Letter.docx	Other-C11_Sponsor Recruitment Letter
C11_Sponsor Recruitment Letter.docx	Other-C11_Sponsor Recruitment Letter
C13_Sponsor Recruitment Call Script.docx	Other-C13_Sponsor Recruitment Call S
C13_Sponsor Recruitment Call Script.docx	Other-C13_Sponsor Recruitment Call S
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
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
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
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.docx	Other-C30_Provider Enrollment Confir
C30_Provider Enrollment Confirmation Email - Spanish.docx	Other-C30_Provider Enrollment Confir
D1_Recruitment Website.docx	Other-D1_Recruitment Website
D1_Recruitment Website.docx	Other-D1_Recruitment Website
D2_Recruitment Website - Spanish.docx	Other-D2_Recruitment Website - Spani
D2_Recruitment Website - Spanish.docx	Other-D2_Recruitment Website - Spani
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
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
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
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: Modified

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-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-C12_Sponsor Recruitment Follow-Up Email	C12_Sponsor Recruitment Follow-Up Email.docx	Yes	No	Printable Only
Other-C14_Sponsor Enrollment Confirmation Email	C14_Sponsor Enrollment Confirmation Email.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-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-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-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-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-E3_Self-Administered Cost Questionnaire	E3_Self-Administered Cost Questionnaire.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
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-C11_Sponsor Recruitment Letter	C11_Sponsor Recruitment Letter.docx	No		Paper Only
Other-C13_Sponsor Recruitment Call Script	C13_Sponsor Recruitment Call Script.docx	No		Paper Only
Other-C15_Endorsement Email to Encourage Provider Participation	C15_Endorsement Email to Encourage Provider Participation.docx	Yes	Yes	Printable Only
Other-C16_Endorsement Email to Encourage Provider Participation - Spanish	C16_Endorsement Email to Encourage Provider Participation - Spanish.docx	Yes	Yes	Printable Only
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-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-C29_Provider Enrollment Confirmation Email	C29_Provider Enrollment Confirmation Email.docx	Yes	No	Printable Only
Other-C30_Provider Enrollment Confirmation Email - Spanish	C30_Provider Enrollment Confirmation Email - Spanish.docx	Yes	No	Printable Only
Other-D1_Recruitment Website	D1_Recruitment Website.docx	Yes	Yes	Fillable Fileable
Other-D2_Recruitment Website - Spanish	D2_Recruitment Website - Spanish.docx	Yes	Yes	Fillable Fileable
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	Yes	Yes	Fillable Printable
Other-E4_Sponsor-Center Cost Interview	E4_Sponsor-Center Cost Interview.docx	Yes	Yes	Fillable Printable
Other-E5_Center Director Cost Interview	E5_Center Director Cost Interview.docx	Yes	Yes	Fillable Printable
Other-E6_Center Food Service Cost Interview	E6_Center Food Service Cost Interview.docx	Yes	Yes	Fillable Printable
Other-F7_Provider Survey	F7_Provider Survey.docx	No		Paper Only
Other-F8_Provider Survey - Spanish	F8_Provider Survey - Spanish.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: 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	Previously Approved
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.