Information Collection

USDA Foods Distribution and Fees Survey

IC 243590 under ICR 201710-0584-003 · OMB 0584-0613.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0613 can be found here:

Documents and Forms

Document Name Document Type
Appendix A.2 USDA Foods Distribution and Fees Survey.docx Other-Appendix A.2 USDA Foods Distri
Appendix A.3 USDA Foods Distribution and Fees Survey - Web Screenshots.docx Other-Appendix A.3 USDA Foods Distri
Appendix A.5 Introductory Email with Survey Link.docx Other-Appendix A.5 Introductory Emai
Appendix A.7. Survey Reminder Phone Calls.docx Other-Appendix A.7. Survey Reminder
Appendix A.8 Post-Survey Response Clarification Email.docx Other-Appendix A.8 Post-Survey Respo
Appendix A.9. Post Survey Claification Phone Call.docx Other-Appendix A.9. Post Survey Clar
Appendix A.6 Survey Reminder Emails.docx Other-Appendix A.6 Survey Reminder E
Appendix A.4. Email Notification from FNS to SDAs.docx Appendix A.4. Email Notification from FNS to SDAs IC Document
Appendix A.10 Cognitive Pretest Memo.docx Appendix A.10 Cognitive Pretest Memo IC Document
QRS USDA Foods Distribution and Fees Survey OMB Clearance Memo 09162020.docx QRS USDA Foods Distribution and Fees Survey OMB Clearance Memo 09162020 IC Document
Appendix A.1 Respondent Burden Table 09162020.xlsx Appendix A.1 Respondent Burden Table IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	USDA Foods Distribution and Fees Survey	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Appendix A.2 USDA Foods Distribution and Fees Survey	Appendix A.2 USDA Foods Distribution and Fees Survey.docx	Yes	Yes	Fillable Fileable
Other-Appendix A.3 USDA Foods Distribution and Fees Survey - Web Screenshots	Appendix A.3 USDA Foods Distribution and Fees Survey - Web Screenshots.docx	No		Paper Only
Other-Appendix A.5 Introductory Email with Survey Link	Appendix A.5 Introductory Email with Survey Link.docx	Yes	Yes	Fillable Fileable
Other-Appendix A.7. Survey Reminder Phone Calls	Appendix A.7. Survey Reminder Phone Calls.docx	No		Paper Only
Other-Appendix A.8 Post-Survey Response Clarification Email	Appendix A.8 Post-Survey Response Clarification Email.docx	Yes	Yes	Fillable Fileable
Other-Appendix A.9. Post Survey Clarification Phone Call	Appendix A.9. Post Survey Claification Phone Call.docx	No		Paper Only
Other-Appendix A.6 Survey Reminder Emails	Appendix A.6 Survey Reminder Emails.docx	Yes	Yes	Fillable Fileable

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: 56 FR 19078

Number of Respondents: 55	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	308	308
Annual IC Time Burden (Hours)	34	34
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Appendix A.4. Email Notification from FNS to SDAs	Appendix A.4. Email Notification from FNS to SDAs.docx	09/11/2020
Appendix A.10 Cognitive Pretest Memo	Appendix A.10 Cognitive Pretest Memo.docx	09/11/2020
QRS USDA Foods Distribution and Fees Survey OMB Clearance Memo 09162020	QRS USDA Foods Distribution and Fees Survey OMB Clearance Memo 09162020.docx	09/16/2020
Appendix A.1 Respondent Burden Table	Appendix A.1 Respondent Burden Table 09162020.xlsx	09/16/2020

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