Individual/Households

NSLP/SBP Access, Participation, Eligibility, and Certification Study

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0530 can be found here:

Documents and Forms

Document Name Document Type
rev062112 Attachment M.1-Household Survey.doc Other-M.1 Household Survey
rev062112 Attachment M.2-Household_Survey_Spanish.doc Other-Attachment M.2-Household_Surve
rev062112 Attachment L.7-Consent for Access to Education Records_CEO.docm Other-Attachment L.7-Consent for Acc
rev062112 Attachment L.8-Consent for Access to Education Records_CEO_Spanish.docm Other-Attachment L.8-National School
rev062112 Attachment L.5-Informed Consent for Participation.docm Other-Attachment L.5-Informed Consen
rev062112 Attachment L.6-Informed Consent for Participation_Spanish.docm Other-Attachment L.6-Informed Consen
rev062112 Attachment L.1-HH Letter.doc Attachment L.1-HH Letter IC Document
rev062112 Attachment L.2-HH Spanish Letter.doc Attachment L.2-HH Spanish Letter IC Document
rev062112 Attachment L.3-National School Meals Brochure.doc Attachment L.3-National School Meals Brochure IC Document
rev062112 Attachment L.4-National School Meals Brochure_Spanish.doc Attachment L.4-National School Meals Brochure_Spanish IC Document

Information Collection (IC) Details

IC Title:	Individual/Households	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-Attachment L.8-National School Meals Brochure_Spanish	rev062112 Attachment L.8-Consent for Access to Education Records_CEO_Spanish.docm	No	Paper Only
Other-Attachment L.5-Informed Consent for Participation	rev062112 Attachment L.5-Informed Consent for Participation.docm	No	Paper Only
Other-Attachment L.6-Informed Consent for Participation_Spanish	rev062112 Attachment L.6-Informed Consent for Participation_Spanish.docm	No	Paper Only
Other-M.1 Household Survey	rev062112 Attachment M.1-Household Survey.doc	No	Paper Only
Other-Attachment M.2-Household_Survey_Spanish	rev062112 Attachment M.2-Household_Survey_Spanish.doc	No	Paper Only
Other-Attachment L.7-Consent for Access to Education Records_CEO	rev062112 Attachment L.7-Consent for Access to Education Records_CEO.docm	No	Paper Only

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: 65 FR 17251

Number of Respondents: 5,529	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	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	0	0	0	0	0	0
Annual IC Time Burden (Hours)	0	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment L.1-HH Letter	rev062112 Attachment L.1-HH Letter.doc	06/27/2012
Attachment L.2-HH Spanish Letter	rev062112 Attachment L.2-HH Spanish Letter.doc	06/27/2012
Attachment L.3-National School Meals Brochure	rev062112 Attachment L.3-National School Meals Brochure.doc	06/27/2012
Attachment L.4-National School Meals Brochure_Spanish	rev062112 Attachment L.4-National School Meals Brochure_Spanish.doc	06/27/2012

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