OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

State, Local, and Tribal Government - State Child Nutrition Agency, SFA, and Schools

IC 226899 under ICR 202208-0584-002 · OMB 0584-0530.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
B1. (Instrument A5) SFA Request for E-Records_Part A Prior SY (Non-CEP Schools for Household Sampling)_v7.docx Other-B1. (Instrument A5) SFA Reques
B1. (Instrument A5) SFA Request for E-Records_Part A Prior SY (Non-CEP Schools for Household Sampling)_v7.docx Other-B1. (Instrument A5) SFA Reques
B3. (Instrument A8) SFA Request for E-Records_Part B Current SY (Non-CEP Schools for Household Sampling)_v6.docx Other-B3. (Instrument A8) SFA Reques
B3. (Instrument A8) SFA Request for E-Records_Part B Current SY (Non-CEP Schools for Household Sampling)_v6.docx Other-B3. (Instrument A8) SFA Reques
B8. (Instrument A1) Application Data Abstraction Form_v4.docx Other-B8. (Instrument A1) Applicatio
B8. (Instrument A1) Application Data Abstraction Form_v4.docx Other-B8. (Instrument A1) Applicatio
B9. (Instrument A2) SFA Request for E-Records (CEP Schools for ISP Data Abstraction)_v5.docx Other-B9. (Instrument A2) SFA Reques
B9. (Instrument A2) SFA Request for E-Records (CEP Schools for ISP Data Abstraction)_v5.docx Other-B9. (Instrument A2) SFA Reques
B11. (Instrument A10) SFA Meal Participation Data Request_v4.docx Other-B11. (Instrument A10) SFA Meal
B11. (Instrument A10) SFA Meal Participation Data Request_v4.docx Other-B11. (Instrument A10) SFA Meal
B12. (Instrument B3) SFA Director Web Survey_v6.docx Other-B12. (Instrument B3) SFA Direc
B12. (Instrument B3) SFA Director Web Survey_v6.docx Other-B12. (Instrument B3) SFA Direc
B13. (Instrument B1) SFA Pre Data Collection Visit_Questionnaire_v6.docx Other-B13. (Instrument B1) SFA Pre D
B13. (Instrument B1) SFA Pre Data Collection Visit_Questionnaire_v6.docx Other-B13. (Instrument B1) SFA Pre D
B14. (Instrument B5) School_Pre Data Collection Visit_Questionnaire_v4.docx Other-B14. (Instrument B5) School_Pr
B14. (Instrument B5) School_Pre Data Collection Visit_Questionnaire_v4.docx Other-B14. (Instrument B5) School_Pr
B15. (Instrument D1) School Meal Count Verification Form_v5.docx Other-B15. (Instrument D1) School Me
B15. (Instrument D1) School Meal Count Verification Form_v5.docx Other-B15. (Instrument D1) School Me
B16. (Instrument D3) SFA Meal Claim Reimbursement Verification Form_all schools_v4.docx Other-B16. (Instrument D3) SFA Meal
B16. (Instrument D3) SFA Meal Claim Reimbursement Verification Form_all schools_v4.docx Other-B16. (Instrument D3) SFA Meal
B17. (Instrument D4) State Meal Claim Data Request_v6.docx Other-B17. (Instrument D4) State Mea
B17. (Instrument D4) State Meal Claim Data Request_v6.docx Other-B17. (Instrument D4) State Mea
B18. (Instrument C1). Meal Observation Booklet_v4.pdf Other-B18. (Instrument C1). Meal Obs
B18. (Instrument C1). Meal Observation Booklet_v4.pdf Other-B18. (Instrument C1). Meal Obs
C1. (Recruitment 003) Official Notification from Rgl Liaisons to State Dir_v6.docx Other-C1. (Recruitment 003) Official
C1. (Recruitment 003) Official Notification from Rgl Liaisons to State Dir_v6.docx Other-C1. (Recruitment 003) Official
C2. (Recruitment 004) SFA Study Notification Template from State CN Director_v2.docx Other-C2. (Recruitment 004) SFA Stud
C2. (Recruitment 004) SFA Study Notification Template from State CN Director_v2.docx Other-C2. (Recruitment 004) SFA Stud
C3. (Recruitment 005) SFA Study Notification and Data Request_v5.docx Other-C3. (Recruitment 005) SFA Stud
C3. (Recruitment 005) SFA Study Notification and Data Request_v5.docx Other-C3. (Recruitment 005) SFA Stud
C4. (Recruitment 006) SFA School Data Verification Reference Guide_v5.docx Other-C4. (Recruitment 006) SFA Scho
C4. (Recruitment 006) SFA School Data Verification Reference Guide_v5.docx Other-C4. (Recruitment 006) SFA Scho
C6. (Recruitment 007) SFA FU DiscGuide (Study Notification and School Data Verification)_v7.docx Other-C6. (Recruitment 007) SFA FU D
C6. (Recruitment 007) SFA FU DiscGuide (Study Notification and School Data Verification)_v7.docx Other-C6. (Recruitment 007) SFA FU D
C7. (Recruitment 008) Automated Email to Confirm Receipt of School Data_v5.docx Other-C7. (Recruitment 008) Automate
C7. (Recruitment 008) Automated Email to Confirm Receipt of School Data_v5.docx Other-C7. (Recruitment 008) Automate
C8. (Recruitment 009) SFA Confirmation and Next Steps Email_v7.docx Other-C8. (Recruitment 009) SFA Conf
C8. (Recruitment 009) SFA Confirmation and Next Steps Email_v7.docx Other-C8. (Recruitment 009) SFA Conf
C9. (Recruitment 010) SFA School Sample Notification Email_v7.docx Other-C9. (Recruitment 010) SFA Scho
C9. (Recruitment 010) SFA School Sample Notification Email_v7.docx Other-C9. (Recruitment 010) SFA Scho
C10. (Recruitment 012) Email Notification Template from SFA to Schools_v6.docx Other-C10. (Recruitment 012) Email N
C10. (Recruitment 012) Email Notification Template from SFA to Schools_v6.docx Other-C10. (Recruitment 012) Email N
C11. (Recruitment 011) SFA Follow Up Discussion Guide (School Sample Notification)_v7.docx Other-C11. (Recruitment 011) SFA Fol
C11. (Recruitment 011) SFA Follow Up Discussion Guide (School Sample Notification)_v7.docx Other-C11. (Recruitment 011) SFA Fol
C12. (Recruitment 013) School Study Notification Letter_v7.docx Other-C12. (Recruitment 013) School
C12. (Recruitment 013) School Study Notification Letter_v7.docx Other-C12. (Recruitment 013) School
C13. (Recruitment 014) School Follow Up Discussion Guide_v5.docx Other-C13. (Recruitment 014) School
C13. (Recruitment 014) School Follow Up Discussion Guide_v5.docx Other-C13. (Recruitment 014) School
C14. (Recruitment 015) School Confirmation Email_v7.docx Other-C14. (Recruitment 015) School
C14. (Recruitment 015) School Confirmation Email_v7.docx Other-C14. (Recruitment 015) School
C15. (Recruitment 016) School Notification of HH Data Collection_v4.docx Other-C15. (Recruitment 016) School
C15. (Recruitment 016) School Notification of HH Data Collection_v4.docx Other-C15. (Recruitment 016) School
C17. (Instrument B1a) SFA Data Collection Initial Visit Contact Email_v3.docx Other-C17. (Instrument B1a) SFA Data
C17. (Instrument B1a) SFA Data Collection Initial Visit Contact Email_v3.docx Other-C17. (Instrument B1a) SFA Data
C18. (Instrument B1b) SFA Data Collection Visit Confirmation Email_v3.docx Other-C18. (Instrument B1b) SFA Data
C18. (Instrument B1b) SFA Data Collection Visit Confirmation Email_v3.docx Other-C18. (Instrument B1b) SFA Data
C20. (Instrument B5a) School Data Collection Visit Confirmation Email_v2.docx Other-C20. (Instrument B5a) School D
C20. (Instrument B5a) School Data Collection Visit Confirmation Email_v2.docx Other-C20. (Instrument B5a) School D
C29. (Recruitment 100) Recruitment 100_APEC IV_Study Website Crosswalk_v7.docx Other-C29. (Recruitment 100) Recruit
C29. (Recruitment 100) Recruitment 100_APEC IV_Study Website Crosswalk_v7.docx Other-C29. (Recruitment 100) Recruit
B19. Meal Observation Pilot Protocol_v2.docx
B19. Meal Observation Pilot Protocol_v2		IC Document
B19. Meal Observation Pilot Protocol_v2.docx
B19. Meal Observation Pilot Protocol_v2		IC Document
B2. (Instrument A6) SFA Reminder for E-Records Part A Prior SY (Non-CEP Schools for Household Sampling)_v6.docx
B2. (Instrument A6) SFA Reminder for E-Records Part A Prior SY (Non-CEP Schools for Household Sampling)_v6		IC Document
B2. (Instrument A6) SFA Reminder for E-Records Part A Prior SY (Non-CEP Schools for Household Sampling)_v6.docx
B2. (Instrument A6) SFA Reminder for E-Records Part A Prior SY (Non-CEP Schools for Household Sampling)_v6		IC Document
B4. (Instrument A9) SFA Reminder for E-Records Part B Current SY (Non-CEP Schools for Household Sampling)_v6.docx
B4. (Instrument A9) SFA Reminder for E-Records Part B Current SY (Non-CEP Schools for Household Sampling)_v6		IC Document
B4. (Instrument A9) SFA Reminder for E-Records Part B Current SY (Non-CEP Schools for Household Sampling)_v6.docx
B4. (Instrument A9) SFA Reminder for E-Records Part B Current SY (Non-CEP Schools for Household Sampling)_v6		IC Document
B10. (Instrument A3) SFA Reminder for E-Records (CEP Schools for ISP Data Abstraction)_v4.docx
B10. (Instrument A3) SFA Reminder for E-Records (CEP Schools for ISP Data Abstraction)_v4		IC Document
B10. (Instrument A3) SFA Reminder for E-Records (CEP Schools for ISP Data Abstraction)_v4.docx
B10. (Instrument A3) SFA Reminder for E-Records (CEP Schools for ISP Data Abstraction)_v4		IC Document
C5. (Recruitment 024) APEC-IV FAQ for States, SFAs, and Schools_v6.docx
C5. (Recruitment 024) APEC-IV FAQ for States, SFAs, and Schools_v6		IC Document
C5. (Recruitment 024) APEC-IV FAQ for States, SFAs, and Schools_v6.docx
C5. (Recruitment 024) APEC-IV FAQ for States, SFAs, and Schools_v6		IC Document
C19. (Instrument B2) SFA Data Collection Visit Reminder Email_v3.docx
C19. (Instrument B2) SFA Data Collection Visit Reminder Email_v3		IC Document
C19. (Instrument B2) SFA Data Collection Visit Reminder Email_v3.docx
C19. (Instrument B2) SFA Data Collection Visit Reminder Email_v3		IC Document
C21a. (Instrument B6) School Data Collection Visit Reminder Email_1 month.docx
C21a. (Instrument B6) School Data Collection Visit Reminder Email_1 month		IC Document
C21a. (Instrument B6) School Data Collection Visit Reminder Email_1 month.docx
C21a. (Instrument B6) School Data Collection Visit Reminder Email_1 month		IC Document
C21b. (Instrument B6) School Data Collection Visit Reminder Email_ 1 week.docx
C21b. (Instrument B6) School Data Collection Visit Reminder Email_ 1 week		IC Document
C21b. (Instrument B6) School Data Collection Visit Reminder Email_ 1 week.docx
C21b. (Instrument B6) School Data Collection Visit Reminder Email_ 1 week		IC Document

Information Collection (IC) Details

View Information Collection (IC)

layout table

Information Collection Instruments:
table that charts list of instruments
Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-B1. (Instrument A5) SFA Request for E-Records_Part A Prior SY (Non-CEP Schools for Household Sampling)_v7 B1. (Instrument A5) SFA Request for E-Records_Part A Prior SY (Non-CEP Schools for Household Sampling)_v7.docx Yes Yes Fillable Fileable
Other-B3. (Instrument A8) SFA Request for E-Records_Part B Current SY (Non-CEP Schools for Household Sampling)_v6 B3. (Instrument A8) SFA Request for E-Records_Part B Current SY (Non-CEP Schools for Household Sampling)_v6.docx Yes Yes Fillable Fileable
Other-B8. (Instrument A1) Application Data Abstraction Form_v4 B8. (Instrument A1) Application Data Abstraction Form_v4.docx Yes Yes Fillable Fileable
Other-B9. (Instrument A2) SFA Request for E-Records (CEP Schools for ISP Data Abstraction)_v5 B9. (Instrument A2) SFA Request for E-Records (CEP Schools for ISP Data Abstraction)_v5.docx Yes Yes Fillable Fileable
Other-B11. (Instrument A10) SFA Meal Participation Data Request_v4 B11. (Instrument A10) SFA Meal Participation Data Request_v4.docx Yes Yes Fillable Fileable
Other-B12. (Instrument B3) SFA Director Web Survey_v6 B12. (Instrument B3) SFA Director Web Survey_v6.docx Yes Yes Fillable Fileable
Other-B13. (Instrument B1) SFA Pre Data Collection Visit_Questionnaire_v6 B13. (Instrument B1) SFA Pre Data Collection Visit_Questionnaire_v6.docx Yes Yes Fillable Fileable
Other-B14. (Instrument B5) School_Pre Data Collection Visit_Questionnaire_v4 B14. (Instrument B5) School_Pre Data Collection Visit_Questionnaire_v4.docx Yes Yes Fillable Fileable
Other-B15. (Instrument D1) School Meal Count Verification Form_v5 B15. (Instrument D1) School Meal Count Verification Form_v5.docx Yes Yes Fillable Fileable
Other-B16. (Instrument D3) SFA Meal Claim Reimbursement Verification Form_all schools_v4 B16. (Instrument D3) SFA Meal Claim Reimbursement Verification Form_all schools_v4.docx Yes Yes Fillable Fileable
Other-B17. (Instrument D4) State Meal Claim Data Request_v6 B17. (Instrument D4) State Meal Claim Data Request_v6.docx Yes Yes Fillable Fileable
Other-B18. (Instrument C1). Meal Observation Booklet_v4 B18. (Instrument C1). Meal Observation Booklet_v4.pdf No   Paper Only
Other-C1. (Recruitment 003) Official Notification from Rgl Liaisons to State Dir_v6 C1. (Recruitment 003) Official Notification from Rgl Liaisons to State Dir_v6.docx Yes Yes Fillable Fileable
Other-C2. (Recruitment 004) SFA Study Notification Template from State CN Director_v2 C2. (Recruitment 004) SFA Study Notification Template from State CN Director_v2.docx Yes Yes Fillable Fileable
Other-C3. (Recruitment 005) SFA Study Notification and Data Request_v5 C3. (Recruitment 005) SFA Study Notification and Data Request_v5.docx Yes Yes Fillable Fileable
Other-C4. (Recruitment 006) SFA School Data Verification Reference Guide_v5 C4. (Recruitment 006) SFA School Data Verification Reference Guide_v5.docx Yes Yes Fillable Fileable
Other-C6. (Recruitment 007) SFA FU DiscGuide (Study Notification and School Data Verification)_v7 C6. (Recruitment 007) SFA FU DiscGuide (Study Notification and School Data Verification)_v7.docx No   Paper Only
Other-C7. (Recruitment 008) Automated Email to Confirm Receipt of School Data_v5 C7. (Recruitment 008) Automated Email to Confirm Receipt of School Data_v5.docx Yes Yes Fillable Fileable
Other-C8. (Recruitment 009) SFA Confirmation and Next Steps Email_v7 C8. (Recruitment 009) SFA Confirmation and Next Steps Email_v7.docx Yes No Fillable Fileable
Other-C9. (Recruitment 010) SFA School Sample Notification Email_v7 C9. (Recruitment 010) SFA School Sample Notification Email_v7.docx Yes No Fillable Fileable
Other-C10. (Recruitment 012) Email Notification Template from SFA to Schools_v6 C10. (Recruitment 012) Email Notification Template from SFA to Schools_v6.docx Yes Yes Fillable Fileable
Other-C11. (Recruitment 011) SFA Follow Up Discussion Guide (School Sample Notification)_v7 C11. (Recruitment 011) SFA Follow Up Discussion Guide (School Sample Notification)_v7.docx No   Paper Only
Other-C12. (Recruitment 013) School Study Notification Letter_v7 C12. (Recruitment 013) School Study Notification Letter_v7.docx Yes Yes Fillable Fileable
Other-C13. (Recruitment 014) School Follow Up Discussion Guide_v5 C13. (Recruitment 014) School Follow Up Discussion Guide_v5.docx No   Paper Only
Other-C14. (Recruitment 015) School Confirmation Email_v7 C14. (Recruitment 015) School Confirmation Email_v7.docx Yes Yes Fillable Fileable
Other-C15. (Recruitment 016) School Notification of HH Data Collection_v4 C15. (Recruitment 016) School Notification of HH Data Collection_v4.docx Yes Yes Fillable Fileable
Other-C17. (Instrument B1a) SFA Data Collection Initial Visit Contact Email_v3 C17. (Instrument B1a) SFA Data Collection Initial Visit Contact Email_v3.docx Yes Yes Fillable Fileable
Other-C18. (Instrument B1b) SFA Data Collection Visit Confirmation Email_v3 C18. (Instrument B1b) SFA Data Collection Visit Confirmation Email_v3.docx Yes Yes Fillable Fileable
Other-C20. (Instrument B5a) School Data Collection Visit Confirmation Email_v2 C20. (Instrument B5a) School Data Collection Visit Confirmation Email_v2.docx Yes Yes Fillable Fileable
Other-C29. (Recruitment 100) Recruitment 100_APEC IV_Study Website Crosswalk_v7 C29. (Recruitment 100) Recruitment 100_APEC IV_Study Website Crosswalk_v7.docx Yes Yes Fillable Fileable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 14,635 0 0 0 0 14,635
Annual IC Time Burden (Hours) 5,235 0 0 0 0 5,235
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
B19. Meal Observation Pilot Protocol_v2 B19. Meal Observation Pilot Protocol_v2.docx 02/09/2022
B2. (Instrument A6) SFA Reminder for E-Records Part A Prior SY (Non-CEP Schools for Household Sampling)_v6 B2. (Instrument A6) SFA Reminder for E-Records Part A Prior SY (Non-CEP Schools for Household Sampling)_v6.docx 02/09/2022
B4. (Instrument A9) SFA Reminder for E-Records Part B Current SY (Non-CEP Schools for Household Sampling)_v6 B4. (Instrument A9) SFA Reminder for E-Records Part B Current SY (Non-CEP Schools for Household Sampling)_v6.docx 02/09/2022
B10. (Instrument A3) SFA Reminder for E-Records (CEP Schools for ISP Data Abstraction)_v4 B10. (Instrument A3) SFA Reminder for E-Records (CEP Schools for ISP Data Abstraction)_v4.docx 02/09/2022
C5. (Recruitment 024) APEC-IV FAQ for States, SFAs, and Schools_v6 C5. (Recruitment 024) APEC-IV FAQ for States, SFAs, and Schools_v6.docx 02/09/2022
C19. (Instrument B2) SFA Data Collection Visit Reminder Email_v3 C19. (Instrument B2) SFA Data Collection Visit Reminder Email_v3.docx 02/09/2022
C21a. (Instrument B6) School Data Collection Visit Reminder Email_1 month C21a. (Instrument B6) School Data Collection Visit Reminder Email_1 month.docx 02/09/2022
C21b. (Instrument B6) School Data Collection Visit Reminder Email_ 1 week C21b. (Instrument B6) School Data Collection Visit Reminder Email_ 1 week.docx 02/09/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.