Information Collection

Travel Outreach Site Intercept Survey

IC 210421 under ICR 201303-0579-001 · OMB 0579-0377.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0579-0377 can be found here:

Documents and Forms

Document Name Document Type
survey.docx Other-Survey Template
template.docx Fast Track Template IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Travel Outreach Site Intercept Survey	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 7 CFR 300-499 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey Template			survey.docx		No		Paper Only

Line of Business: Natural Resources

Subfunction: Agricultural Innovation and Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,000	2,000
Annual IC Time Burden (Hours)	340	340
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Fast Track Template	template.docx	02/25/2014

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