Information Collection

Sponsors and Sites

IC 211308 under ICR 201404-0584-009 · OMB 0584-0595.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0595 can be found here:

Documents and Forms

Document Name Document Type
Appendix F1 Sponsor Survey Instrument.docx www.surveymonkey.com Other-Appendix F1 Sponsor Survey Ins
Appendix G1 Site Survey Instrument.docx www.surveymonkey.com Other-Appendix G1 Site Survey Instru
Appendix A1 Online Survey Screen Shots for OMB.docx www.surveymonkey.com Other-Appendix A1 Online Survey Scre
Appendix F2 Sponsor MOU.doc Appendix F2 Sponsor MOU IC Document
Appendix F3 Sponsor Survey E-mail Invite Text-Script.docx Appendix F3 Sponsor Survey E-mail Invite Text-Script IC Document
Appendix F4 Sponsor Intro Letter.docx Appendix F4 Sponsor Intro Letter IC Document
Appendix F5 Sponsor Survey Reminder Text-Script.docx Appendix F5 Sponsor Survey Reminder Text-Script IC Document
Appendix F6 Sponsor Webinar.pptx Appendix F6 Sponsor Webinar IC Document
Appendix F7 Sponsor Webinar Save the Date.docx Appendix F7 Sponsor Webinar Save the Date IC Document
Appendix G2 Site Survey E-mail Invite Text-Script.docx Appendix G2 Site Survey E-mail Invite Text-Script IC Document
Appendix G3 Site Intro Letter.docx Appendix G3 Site Intro Letter IC Document
Appendix G4 Site Survey Reminder Text-Script.docx Appendix G4 Site Survey Reminder Text-Script IC Document
Appendix G5 Site Info Request.docx Appendix G5 Site Info Request IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Sponsors and Sites	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Appendix F1 Sponsor Survey Instrument	Appendix F1 Sponsor Survey Instrument.docx	www.surveymonkey.com	Yes	Yes	Fillable Fileable Signable
Other-Appendix G1 Site Survey Instrument	Appendix G1 Site Survey Instrument.docx	www.surveymonkey.com	Yes	Yes	Paper Only
Other-Appendix A1 Online Survey Screen Shots	Appendix A1 Online Survey Screen Shots for OMB.docx	www.surveymonkey.com	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 650	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	9,201	9,201
Annual IC Time Burden (Hours)	2,071	2,071
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Appendix F2 Sponsor MOU	Appendix F2 Sponsor MOU.doc	04/23/2014
Appendix F3 Sponsor Survey E-mail Invite Text-Script	Appendix F3 Sponsor Survey E-mail Invite Text-Script.docx	04/23/2014
Appendix F4 Sponsor Intro Letter	Appendix F4 Sponsor Intro Letter.docx	04/23/2014
Appendix F5 Sponsor Survey Reminder Text-Script	Appendix F5 Sponsor Survey Reminder Text-Script.docx	04/23/2014
Appendix F6 Sponsor Webinar	Appendix F6 Sponsor Webinar.pptx	04/23/2014
Appendix F7 Sponsor Webinar Save the Date	Appendix F7 Sponsor Webinar Save the Date.docx	04/23/2014
Appendix G2 Site Survey E-mail Invite Text-Script	Appendix G2 Site Survey E-mail Invite Text-Script.docx	04/23/2014
Appendix G3 Site Intro Letter	Appendix G3 Site Intro Letter.docx	04/23/2014
Appendix G4 Site Survey Reminder Text-Script	Appendix G4 Site Survey Reminder Text-Script.docx	04/23/2014
Appendix G5 Site Info Request	Appendix G5 Site Info Request.docx	04/23/2014

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