Information Collection

Individual/Households

IC 202242 under ICR 201204-0584-007 · OMB 0584-0530.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0530 can be found here:

Documents and Forms

Document Name Document Type
rev062112 Attachment M.1-Household Survey.doc Other-M.1 Household Survey
rev062112 Attachment M.2-Household_Survey_Spanish.doc Other-Attachment M.2-Household_Surve
rev062112 Attachment L.7-Consent for Access to Education Records_CEO.docm Other-Attachment L.7-Consent for Acc
rev062112 Attachment L.8-Consent for Access to Education Records_CEO_Spanish.docm Other-Attachment L.8-National School
rev062112 Attachment L.5-Informed Consent for Participation.docm Other-Attachment L.5-Informed Consen
rev062112 Attachment L.6-Informed Consent for Participation_Spanish.docm Other-Attachment L.6-Informed Consen
rev062112 Attachment L.1-HH Letter.doc Attachment L.1-HH Letter IC Document
rev062112 Attachment L.2-HH Spanish Letter.doc Attachment L.2-HH Spanish Letter IC Document
rev062112 Attachment L.3-National School Meals Brochure.doc Attachment L.3-National School Meals Brochure IC Document
rev062112 Attachment L.4-National School Meals Brochure_Spanish.doc Attachment L.4-National School Meals Brochure_Spanish IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Individual/Households	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-M.1 Household Survey	rev062112 Attachment M.1-Household Survey.doc	No	Paper Only
Other-Attachment M.2-Household_Survey_Spanish	rev062112 Attachment M.2-Household_Survey_Spanish.doc	No	Paper Only
Other-Attachment L.7-Consent for Access to Education Records_CEO	rev062112 Attachment L.7-Consent for Access to Education Records_CEO.docm	No	Paper Only
Other-Attachment L.8-National School Meals Brochure_Spanish	rev062112 Attachment L.8-Consent for Access to Education Records_CEO_Spanish.docm	No	Paper Only
Other-Attachment L.5-Informed Consent for Participation	rev062112 Attachment L.5-Informed Consent for Participation.docm	No	Paper Only
Other-Attachment L.6-Informed Consent for Participation_Spanish	rev062112 Attachment L.6-Informed Consent for Participation_Spanish.docm	No	Paper Only

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: 65 FR 17251

Number of Respondents: 5,529	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	5,529	5,529
Annual IC Time Burden (Hours)	3,373	3,373
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment L.1-HH Letter	rev062112 Attachment L.1-HH Letter.doc	06/27/2012
Attachment L.2-HH Spanish Letter	rev062112 Attachment L.2-HH Spanish Letter.doc	06/27/2012
Attachment L.3-National School Meals Brochure	rev062112 Attachment L.3-National School Meals Brochure.doc	06/27/2012
Attachment L.4-National School Meals Brochure_Spanish	rev062112 Attachment L.4-National School Meals Brochure_Spanish.doc	06/27/2012

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