SNAP Teen Nutrition Pilot Testing (Parents/Students)

FNS Generic Clearance For Pre-Testing, Pilot, And Field Test Studies

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0606 can be found here:

Documents and Forms

Document Name Document Type
Attachment A - Quantitative Evaluation Survey for High School Students 0...-1.docx Other-Attachment A - Quantitative Ev
Attachment B - Moderator PRE - Discussion Guide for Focus Groups with Hi....docx Other-Attachment B - Moderator PRE -
Attachment C - Moderator POST - Discussion Guide for Focus Groups with High School Students060116.docx Other-Attachment C - Moderator POST
Attachment F - Parent Guardian Focus Group Consent Form for Student Participation 060116.docx Other-Attachment F - Parent Guardian
0584-0606 FNS SNAP Teen Nutrition Pilot Test OMB Package Memo 7-12-16 clean version-1.docx OMB Justification Memo IC Document
Attachment G - Teen Nutrition and Physical Activity Program 060216.pdf Attachment G - Teen Nutrition and Physical Activity Program 060216 IC Document

Information Collection (IC) Details

IC Title:	SNAP Teen Nutrition Pilot Testing (Parents/Students)	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 A - Quantitative Evaluation Survey for High School Students 0...-1	Attachment A - Quantitative Evaluation Survey for High School Students 0...-1.docx	No	Paper Only
Other-Attachment B - Moderator PRE - Discussion Guide for Focus Groups with High School Students	Attachment B - Moderator PRE - Discussion Guide for Focus Groups with Hi....docx	No	Paper Only
Other-Attachment C - Moderator POST - Discussion Guide for Focus Groups with High School Students060116	Attachment C - Moderator POST - Discussion Guide for Focus Groups with High School Students060116.docx	No	Printable Only
Other-Attachment F - Parent Guardian Focus Group Consent Form for Student Participation 060116	Attachment F - Parent Guardian Focus Group Consent Form for Student Participation 060116.docx	No	Paper Only

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 295	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	635	635
Annual IC Time Burden (Hours)	313	313
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
OMB Justification Memo	0584-0606 FNS SNAP Teen Nutrition Pilot Test OMB Package Memo 7-12-16 clean version-1.docx	07/12/2016
Attachment G - Teen Nutrition and Physical Activity Program 060216	Attachment G - Teen Nutrition and Physical Activity Program 060216.pdf	07/12/2016

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