Information Collection

What You Can Do for School Wellness Communication Tools Testing

IC 198156 under ICR 201207-0584-007 · OMB 0584-0524.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0524 can be found here:

Documents and Forms

Document Name Document Type
What You Can Do for School Wellness Communication Tools Testing Form and Instruction
A_FNS screener_students_FINAL.docx Form and Instruction
B_FNS screener_parents_FINAL.docx Form and Instruction
C_Screener_Teachers_FINAL.docx Form and Instruction
D_FNS screener_principals_FINAL.docx Form and Instruction
E_Screener_Food Service Managers_FINAL.docx Form and Instruction
F_Evaluative Guide_Students_FINAL.docx Form and Instruction
G_Evaluative Guide_Parents_Final Revised.docx Form and Instruction
H_Evaluative Guide_Teachers_Final Revised.docx Form and Instruction
I_Evaluative Guide_Principals_Final Revised.docx Form and Instruction
J_Evaluative Guide_Food Service Managers_Final Revised.docx Form and Instruction
K_Attachment.pdf Form and Instruction
L - Agreement on Security of Comments_Adults_FINAL.docx Form and Instruction
M - Agreement on Security of Comments_parents_FINAL.docx Form and Instruction
N - Parental consent form_FINAL.docx Form and Instruction
OMB_Justification_Request.Evaluative_Stage_7_1_11.docx Generic IC Request - Communications Tools Testing Memo (Second Phase) IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	What You Can Do for School Wellness Communication Tools Testing	Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form and Instruction	NA	NA	A_FNS screener_students_FINAL.docx	No	Paper Only
Form and Instruction	NA	NA	B_FNS screener_parents_FINAL.docx	No	Paper Only
Form and Instruction	NA	NA	C_Screener_Teachers_FINAL.docx	No	Paper Only
Form and Instruction	NA	NA	D_FNS screener_principals_FINAL.docx	No	Paper Only
Form and Instruction	NA	NA	E_Screener_Food Service Managers_FINAL.docx	No	Paper Only
Form and Instruction	NA	NA	F_Evaluative Guide_Students_FINAL.docx	No	Paper Only
Form and Instruction	NA	NA	G_Evaluative Guide_Parents_Final Revised.docx	No	Paper Only
Form and Instruction	NA	NA	H_Evaluative Guide_Teachers_Final Revised.docx	No	Paper Only
Form and Instruction	NA	NA	I_Evaluative Guide_Principals_Final Revised.docx	No	Paper Only
Form and Instruction	NA	NA	J_Evaluative Guide_Food Service Managers_Final Revised.docx	No	Paper Only
Form and Instruction	NA	NA	K_Attachment.pdf	No	Paper Only
Form and Instruction	NA	NA	L - Agreement on Security of Comments_Adults_FINAL.docx	No	Paper Only
Form and Instruction	NA	NA	M - Agreement on Security of Comments_parents_FINAL.docx	No	Paper Only
Form and Instruction	NA	NA	N - Parental consent form_FINAL.docx	No	Paper Only

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,308	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	4,308	4,308
Annual IC Time Burden (Hours)	763	763
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Generic IC Request - Communications Tools Testing Memo (Second Phase)	OMB_Justification_Request.Evaluative_Stage_7_1_11.docx	07/12/2011

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