State/Local: O - Program Data

ATTACHMENT O.3-ADMINISTRATIVE DATE ITEMS

ADMINISTRATIVE DATA ITEMS BEING REQUESTED FROM STATE AGENCIES

District-Level NSLP and SBP Program Data

(A) Separately for each district in the state or territory:

1. Number of reimbursable meals

1. Number of reimbursable NSLP lunches: separately by free; reduced-price; paid; and total

2. Number of reimbursable SBP breakfasts: separately by free; reduced-price; paid; and total

2. Number of schools by Provision 2/3 status

1. Total number of Provision 2/3 schools

2. Number of Provision 2/3 school with SBP only

3. Number of Provision 2/3 school with NSLP only

4. Number of Provision 2/3 school with both SBP and NSLP

5. Number of Non-Provision schools

6. Total number of Provision 2/3 and Non-Provision 2/3 schools

3. Number of schools by participation in the Community Eligibility Option (CEO)

1. Total number of schools participating in the CEO

2. Number of schools that are participating in CEO individually

3. Number of groups of schools that are participating in CEO jointly (District wide participation would be considered a group)

4. Number of schools in each group of schools that is participating in CEO jointly

5. Number of Non-CEO schools

6. Total number of CEO and non-CEO schools

4. Number of students in schools by Provision 2/3 status

1. Total number of students in Provision 2/3 schools

2. Number of students in Provision 2/3 school with SBP only

3. Number of students in Provision 2/3 school with NSLP only

4. Number of students in Provision 2/3 school with both SBP and NSLP

5. Number of students in Non-Provision schools

6. Total number of students in Provision 2/3 and Non-Provision 2/3 schools

5. Number of students in schools by participation in the Community Eligibility Option (CEO)

1. Total number of students in schools that are participating in the CEO

2. Number of enrolled students in each school that is participating in CEO individually

3. Number of enrolled students in each school that is participating in CEO individually, as of April 1 in each school’s reference year for CEO

4. Number of directly certified students in each school that is participating in CEO individually, as of April 1 in each school’s reference year for CEO

5. Number of enrolled students in each group of schools that is participating in CEO jointly, as of April 1 in each group’s reference year for CEO

6. Number of directly certified students in each group of schools that is participating in CEO jointly, as of April 1 in each group’s reference year for CEO

7. Number of enrolled students in Non-CEO schools

8. Total number of students in CEO and non-CEO schools

(B) For the entire state:

Totals across all districts for the entire state for each of the items (1)a – (1)b, (2)a – (2)f; (3)a – (3)f; (4)a – (4)f; and (5)a – (5)h.

IN CEO STATES:

Assistance program participation lists, as of April 1, 2011 and April 1, 2010

(If it is easier to provide consolidated lists of participants in relevant assistance programs, rather than separate lists, that is acceptable)

(C) State-wide lists of:

(1) Supplemental Nutrition Assistance Program (SNAP) participants, including:

(a) First name

(b) Middle name

(c) Last name

(d) Street address

(e) Mailing address

(f) Name of other household members (adults and children)

(g) Last 4 digits of Social Security Number for each adult household member

(h) Gender of household members under age 18

(i) Race of household members under age 18

(j) Ethnicity of household members under age 18

(k) Date of birth of household members under age 18

(l) Date of SNAP certification

(2) Food Distribution Program on Indian Reservation (FDPIR) participants, including:

(a) First name

(b) Middle name

(c) Last name

(d) Street address

(e) Mailing address

(f) Name of other household members (adults and children)

(g) Last 4 digits of Social Security Number for each adult household member

(h) Gender of household members under age 18

(i) Race of household members under age 18

(j) Ethnicity of household members under age 18

(k) Date of birth of household members under age 18

(l) Date of FDPIR certification

(3) Temporary Assistance for Needy Families (TANF) participants, including:

(a) First name

(b) Middle name

(c) Last name

(d) Street address

(e) Mailing address

(f) Name of other household members (adults and children)

(g) Last 4 digits of Social Security Number for each adult household member

(h) Gender of household members under age 18

(i) Race of household members under age 18

(j) Ethnicity of household members under age 18

(k) Date of birth of household members under age 18

(l) Date of TANF certification

(4) Migrant Education Program (MEP) participants, including:

(a) First name

(b) Middle name

(c) Last name

(d) Street address

(e) Mailing address

(f) Gender

(g) Race

(h) Ethnicity

(i) Date of birth

(j) Date of MEP enrollment

(5) Participants in programs under the Runaway and Homeless Youth Act, including, including:

(a) First name

(b) Middle name

(c) Last name

(d) Street address

(e) Mailing address

(f) Gender

(g) Race

(h) Ethnicity

(i) Date of birth

(j) Date of program enrollment

(6) Participants in any local programs serving migrant, homeless, or runaway students, including:

(a) First name

(b) Middle name

(c) Last name

(d) Street address

(e) Mailing address

(f) Gender

(g) Race

(h) Ethnicity

(i) Date of birth

(j) Date of program enrollment

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this collection is 0584-0530. The time required to complete this information collection is estimated to average 8 hours per response, including the time to review instructions, searching existing data resources, gather the data needed, and complete and review the information collected.

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