Survey to Collect Information on the use of MyPlate Materials in the Supplemental Nutrition Assistance Program Education (SNAP-Ed) Clearinghouse.

FNS Fast Track Clearance for the Collection of Routine Customer Feedback

Documents and Forms

Document Name Document Type
SNAP-Ed Interventions MyPlate Survey_0584-0611 Generic IC_6.25.24 clean.docx Instruction
Attachment C. SNAP-Ed Interventions MyPlate Survey potential respondent list_6.24.24.xlsx Attachment C SNAP Ed Interventions MyPlate Survey Respondents List IC Document
Attachment A. SNAP-Ed Interventions MyPlate Survey screen shots 7-29-24 revised.pdf Appendix A SNAP Ed Interventions MyPlate Survey Screen Shots IC Document
Attachment B. SNAP-Ed Interventions MyPlate Survey sample email for intervention developers_7-29-24 revised.docx Appendix B SNAP Ed Interventions MyPlate Survey Sample Email IC Document

Information Collection (IC) Details

IC Title:	Survey to Collect Information on the use of MyPlate Materials in the Supplemental Nutrition Assistance Program Education (SNAP-Ed) Clearinghouse.	Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation: 7 CFR 272.2

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			SNAP-Ed Interventions MyPlate Survey_0584-0611 Generic IC_6.25.24 clean.docx		Yes	Yes	Fillable Printable

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 110	Number of Respondents for Small Entity: 68

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	110	110
Annual IC Time Burden (Hours)	28	28
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment C SNAP Ed Interventions MyPlate Survey Respondents List	Attachment C. SNAP-Ed Interventions MyPlate Survey potential respondent list_6.24.24.xlsx	07/02/2024
Appendix A SNAP Ed Interventions MyPlate Survey Screen Shots	Attachment A. SNAP-Ed Interventions MyPlate Survey screen shots 7-29-24 revised.pdf	07/30/2024
Appendix B SNAP Ed Interventions MyPlate Survey Sample Email	Attachment B. SNAP-Ed Interventions MyPlate Survey sample email for intervention developers_7-29-24 revised.docx	07/30/2024

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