State, Local, and Tribal Government - State Child Nutrition Agency, SFA, and Schools

Third Access, Participation, Eligibility and Certification Study Series (APEC III)

OMB: 0584-0530

IC ID: 226899

Documents and Forms
Document Name
Document Type
Other-Appendix B1. SFA Request for E
Other-Appendix B2. SFA Reminder for
Other-Appendix B3. SFA Request for E
Other-Appendix B4. SFA Reminder for
Other-Appendix B5. SFA Pre-Visit Int
Other-Appendix B7. Application Data
Other-Appendix B8. Round 2 & 3 Appli
Other-Appendix B9. SFA Reimbursement
Other-Appendix B10. SFA Reimbursemen
Other-Appendix B11. SFA Director Sur
Other-Appendix B12. SFA Director Int
Other-Appendix B13. SFA Meal Partici
Other-Appendix B14. State Meal Claim
Other-Appendix C1. School Pre-Visit
Other-Appendix C3. Meal Transaction
Other-Appendix C5. Cafeteria Manager
Other-Appendix C6. School Meal Count
Other-Appendix O2. Template E-Letter
Other-Appendix O3. State Follow Up C
Other-Appendix O4. SFA Study Notific
Other-Appendix O5. SFA Follow Up Con
Other-Appendix O8. SFA School Sample
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

State, Local, and Tribal Government - State Child Nutrition Agency, SFA, and Schools
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Appendix B1. SFA Request for E-Records (Non-CEP Schools for Household Sampling) B01 SFA Request for E-Records (Non-CEP schools for Household Sampling).docx Yes Yes Fillable Fileable
Other-Appendix B2. SFA Reminder for E-Records (Non-CEP Schools for Household Sampling) B02 SFA Reminder for E-Records (Non-CEP Schools for Household Sampling).docx Yes Yes Fillable Fileable
Other-Appendix B3. SFA Request for E-Records (CEP Schools for ISP Data Abstraction) B03 SFA Request for E-Records (CEP Schools for ISP Data Abstraction).docx Yes Yes Fillable Fileable
Other-Appendix B4. SFA Reminder for E-Records (CEP Schools for ISP Data Abstraction) B04 SFA Reminder for E-Records (CEP Schools for ISP Data Abstraction).docx Yes Yes Fillable Fileable
Other-Appendix B5. SFA Pre-Visit Interview B05 SFA Pre-Visit Interview.docx Yes Yes Paper Only
Other-Appendix B7. Application Data Abstraction Form B07 Application Data Abstraction Form.docx Yes Yes Fillable Fileable
Other-Appendix B8. Round 2 & 3 Application Data Abstraction Scheduling Email B08 Round 2 & 3 Application Data Abstraction Scheduling Email.docx Yes Yes Fillable Fileable
Other-Appendix B9. SFA Reimbursement Claim Verification Form - Sampled Schools B09 SFA Reimbursement Claim Verification Form - Sampled Schools.docx Yes Yes Fillable Fileable
Other-Appendix B10. SFA Reimbursement Consolidation and Claim Verification Form - All Schools B10 SFA Reimbursement Consolidation and Claim Verification Form - All Schools.docx Yes Yes Fillable Fileable
Other-Appendix B11. SFA Director Survey (web based) B11 SFA Director Survey (Web Based).docx Yes Yes Fillable Fileable
Other-Appendix B12. SFA Director Interview (by phone) B12 SFA Director Interview (By Phone).docx No   Paper Only
Other-Appendix B13. SFA Meal Participation Data Request B13 SFA Meal Participation Data Request.docx Yes Yes Fillable Fileable
Other-Appendix B14. State Meal Claim Data Request B14 State Meal Claim Data Request.docx Yes Yes Fillable Fileable
Other-Appendix C1. School Pre-Visit Interview C01 School Pre-Visit Interview.docx Yes No Fillable Printable
Other-Appendix C3. Meal Transaction Observation Form C03 Meal Transaction Observation Form.docx No   Paper Only
Other-Appendix C5. Cafeteria Manager Interview C05 Cafeteria Manager Interview.docx No   Paper Only
Other-Appendix C6. School Meal Count Verification Form C06 School Meal Count Verification Form.docx No   Paper Only
Other-Appendix O8. SFA School Sample Notification E-Letter O08 SFA School Sample Notification E-Letter.docx Yes Yes Fillable Fileable
Other-Appendix O2. Template E-Letter from FNS Regional Liaison to State Child Nutrition Director O02 Template E-Letter from FNS Regional Liaison to State Child Nutrition Director.docx Yes No Fillable Printable
Other-Appendix O3. State Follow Up Contact Guide O03 State Follow Up Contact Guide.docx No   Paper Only
Other-Appendix O4. SFA Study Notification and School Data Verification E-Letter O04 SFA Study Notification and School Data Verification E-Letter.pdf Yes Yes Fillable Fileable
Other-Appendix O5. SFA Follow Up Contact Guide (Study Notification and School Data Verification) O05 SFA Follow Up Contact Guide (Study Notification and School Data Verification).docx Yes No Fillable Printable

Income Security Food and Nutrition Assistance

FNS-8 USDA/FNS Studies and Reports  56 FR 19078

2,801 19
   
State, Local, and Tribal Governments
 
   21 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 10,084 0 10,084 0 0 0
Annual IC Time Burden (Hours) 4,521 0 4,521 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Appendix B6. SFA Data Collection Visit Reminder Email B06 SFA Data Collection Visit Reminder Email.docx 05/17/2017
Appendix C4. Example of Meal Transaction Sampling C04 Example of Meal Transaction Sampling 6.20.17.docx 06/20/2017
Appendix C2. School Data Collection Visit Reminder Email C02 School Data Collection Visit Reminder Email.docx 05/17/2017
Appendix O6. SFA Automated Email - Receipt of Verification of School Data O06 SFA Automated Email - Receipt of Verification of School Data.docx 05/18/2017
Appendix O7. SFA Confirmation and Next Steps Email O07 SFA Confirmation and Next Steps Email.docx 05/18/2017
Appendix O9. School Study Notification E-Letter O09 School Study Notification E-Letter.docx 05/18/2017
Appendix O10. APEC III Fact Sheet (for SFAs and Schools) O10 APEC III Fact Sheet (For SFAs and Schools).docx 05/18/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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