Digital Nutrition Education Materials for Middle School Students (Individuals/Households) - IC 2 of 2

Generic Clearance to Conduct Formative Research

⚠️ Notice: This information collection may be referencing outdated material.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
Attachment B_Consent Package for Parent Final.docx Other-Attachment B Consent Packge fo
Attachment C_Student Focus Group Package_Grade 6_Final.docx Other-Attachment C Student Focus Gro
Attachment D_Student Survey Grade 6 Final.docx Other-Attachment D Student Survey: G
Attachment E_Student Focus Group Package_Grade 7 Final.docx Other-Attachment E Student Focus Gro
Attachment F_Student Survey Grade 7 Final.docx Other-Attachment F Student Survey: G
Attachment G_Student Focus Group Package_Grade 8 Final.docx Other-Attachment G Student Focus Gro
Attachment H_Student Survey Grade 8 Final.docx Other-Attachment H Student Survey: G
20170223 Middle School Digital Nutrition Pilot_OMB Memo_FInal.pdf 20170223 Middle School Digital Nutrition Pilot_OMB Memo_FInal IC Document

Information Collection (IC) Details

IC Title:	Digital Nutrition Education Materials for Middle School Students (Individuals/Households) - IC 2 of 2	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-Attachment B Consent Packge for Parent/Caregivers: Parent/Caregiver Consent Cover Letter, Parent/Caregiver Passive Consent Information	Attachment B_Consent Package for Parent Final.docx	No	Paper Only
Other-Attachment C Student Focus Group Package for Grade 6: Student Focus Group Guideline, Student Focus Group Questionnaire	Attachment C_Student Focus Group Package_Grade 6_Final.docx	No	Paper Only
Other-Attachment D Student Survey: Grade 6	Attachment D_Student Survey Grade 6 Final.docx	No	Paper Only
Other-Attachment E Student Focus Group Package for Grade 7: Student Focus Group Guideline, Student Focus Group Questionnaire	Attachment E_Student Focus Group Package_Grade 7 Final.docx	No	Paper Only
Other-Attachment F Student Survey: Grade 7	Attachment F_Student Survey Grade 7 Final.docx	No	Paper Only
Other-Attachment G Student Focus Group Package for Grade 8: Student Focus Group Guideline, Student Focus Group Questionnaire	Attachment G_Student Focus Group Package_Grade 8 Final.docx	No	Paper Only
Other-Attachment H Student Survey: Grade 8	Attachment H_Student Survey Grade 8 Final.docx	No	Paper Only

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title: FNS-8 FNS Studies and Reports	FR Citation: 56 FR 19078

Number of Respondents: 2,240	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	3,226	3,226
Annual IC Time Burden (Hours)	744	744
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
20170223 Middle School Digital Nutrition Pilot_OMB Memo_FInal	20170223 Middle School Digital Nutrition Pilot_OMB Memo_FInal.pdf	02/28/2017

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