FDPIR Tribal Leaders, Managers, Staff (State/Local/ Tribal Government)

Study of the Food Distribution Program on Indian Reservations (FDPIR)

OMB: 0584-0583

IC ID: 206347

Documents and Forms

Document Name Document Type
ATTACHMENT B1a - Case Record Review.docx Other-ATTACHMENT B1a - Case Record R
ATTACHMENT B1c - Case Record Review Pretest Outreach Script.docx Other-ATTACHMENT B1c - Case Record R
ATTACHMENT B2d - Pretest Debriefing Guide.doc Other-ATTACHMENT B2d - Pretest Debri
ATTACHMENT B4a - Onsite Official Interview Guide.docx Other-ATTACHMENT B4a - Onsite Offici
04 24 13 ATTACHMENT B4c - Call Script for Site Visit Planning with FDPIR Director.doc Other-ATTACHMENT B4c - Call Script f
ATTACHMENT B4d - Onsite Official Interview Outreach Script.doc Other-ATTACHMENT B4d - Onsite Offici
ATTACHMENT B4e - Onsite Official Interview Pretest Outreach Email.docx Other-ATTACHMENT B4e - Onsite Offici
ATTACHMENT I1 - FDPIR Letter # 1 - To Tribal Leadership from USDA.docx Other-ATTACHMENT I1 - FDPIR Letter #
ATTACHMENT I2 - FDPIR Letter # 2 - To FDPIR Director from USDA_OUTREACH-RECRUITMENT.docx Other-ATTACHMENT I2 - FDPIR Letter #
ATTACHMENT I3 - FDPIR Letter # 3 - To FDPIR Director from USDA.docx Other-ATTACHMENT I3 - FDPIR Letter #
ATTACHMENT I5 - FDPIR Letter # 5 - To Tribal Leadership from Urban Institute.docx Other-ATTACHMENT I5 - FDPIR Letter #
ATTACHMENT J - INVITATION TO THE RESERVATION TEMPLATE.docx Other-ATTACHMENT J - INVITATION TO T
04 16 13 ATTACHMENT B1b - Case Record Review Template.docx ATTACHMENT B1b - Case Record Review Template.pdf IC Document
ATTACHMENT B4b - Site Visit Checklists.docx ATTACHMENT B4b - Site Visit Checklists.docx IC Document
ATTACHMENT K - Procedures for Accessing Case Records and Abstracting Data.docx ATTACHMENT K - Procedures for Accessing Case Records and Abstracting Data.docx IC Document
ATTACHMENT L - Responsibilities of Field Interviewers.docx ATTACHMENT L - Responsibilities of Field Interviewers.docx IC Document
ATTACHMENT M - Procedures for Conducting Site Visits.docx ATTACHMENT M - Procedures for Conducting Site Visits.docx IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	FDPIR Tribal Leaders, Managers, Staff (State/Local/ Tribal Government)	Agency IC Tracking Number:

Is this a Common Form? No		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-ATTACHMENT B1a - Case Record Review.docx	ATTACHMENT B1a - Case Record Review.docx	No		Paper Only
Other-ATTACHMENT B1c - Case Record Review Pretest Outreach Script.docx	ATTACHMENT B1c - Case Record Review Pretest Outreach Script.docx	No		Paper Only
Other-ATTACHMENT B2d - Pretest Debriefing Guide.doc	ATTACHMENT B2d - Pretest Debriefing Guide.doc	Yes	Yes	Fillable Fileable
Other-ATTACHMENT B4a - Onsite Official Interview Guide.docx	ATTACHMENT B4a - Onsite Official Interview Guide.docx	Yes	Yes	Fillable Fileable
Other-ATTACHMENT B4c - Call Script for Site Visit Planning with FDPIR Director.doc	04 24 13 ATTACHMENT B4c - Call Script for Site Visit Planning with FDPIR Director.doc	Yes	Yes	Fillable Fileable
Other-ATTACHMENT B4d - Onsite Official Interview Outreach Script.doc	ATTACHMENT B4d - Onsite Official Interview Outreach Script.doc	Yes	Yes	Fillable Fileable
Other-ATTACHMENT B4e - Onsite Official Interview Pretest Outreach Email.docx	ATTACHMENT B4e - Onsite Official Interview Pretest Outreach Email.docx	Yes	Yes	Fillable Fileable
Other-ATTACHMENT I1 - FDPIR Letter # 1 - To Tribal Leadership from USDA.docx	ATTACHMENT I1 - FDPIR Letter # 1 - To Tribal Leadership from USDA.docx	Yes	Yes	Fillable Fileable
Other-ATTACHMENT I2 - FDPIR Letter # 2 - To FDPIR Director from USDA_OUTREACH-RECRUITMENT.docx	ATTACHMENT I2 - FDPIR Letter # 2 - To FDPIR Director from USDA_OUTREACH-RECRUITMENT.docx	Yes	Yes	Fillable Fileable
Other-ATTACHMENT I3 - FDPIR Letter # 3 - To FDPIR Director from USDA.docx	ATTACHMENT I3 - FDPIR Letter # 3 - To FDPIR Director from USDA.docx	Yes	Yes	Fillable Fileable
Other-ATTACHMENT I5 - FDPIR Letter # 5 - To Tribal Leadership from Urban Institute.docx	ATTACHMENT I5 - FDPIR Letter # 5 - To Tribal Leadership from Urban Institute.docx	Yes	Yes	Fillable Fileable
Other-ATTACHMENT J - INVITATION TO THE RESERVATION TEMPLATE.docx	ATTACHMENT J - INVITATION TO THE RESERVATION TEMPLATE.docx	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title: (SORN) FNS-8 USDA/FNS Studies and Reports	FR Citation: 56 FR 19078

Number of Respondents: 202	Number of Respondents for Small Entity: 3

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 5 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,528	1,528
Annual IC Time Burden (Hours)	248	248
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
ATTACHMENT B1b - Case Record Review Template.pdf	04 16 13 ATTACHMENT B1b - Case Record Review Template.docx	04/24/2013
ATTACHMENT B4b - Site Visit Checklists.docx	ATTACHMENT B4b - Site Visit Checklists.docx	04/04/2013
ATTACHMENT K - Procedures for Accessing Case Records and Abstracting Data.docx	ATTACHMENT K - Procedures for Accessing Case Records and Abstracting Data.docx	04/04/2013
ATTACHMENT L - Responsibilities of Field Interviewers.docx	ATTACHMENT L - Responsibilities of Field Interviewers.docx	04/04/2013
ATTACHMENT M - Procedures for Conducting Site Visits.docx	ATTACHMENT M - Procedures for Conducting Site Visits.docx	04/04/2013

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