Appendix N. APEC III Burden Table

					Responsive					Non-Responsive
Respondent Category	Type of respondents	Instruments	Appendix	Sample Sizea	Number of respondents	Frequency of response	Total Annual responses	Hours per response	Annual burden (hours)	Number of Non-respondents	Frequency of response	Total Annual responses	Hours per response	Annual burden (hours)	Grand Total Annual Burden Estimate (hours)	Hourly Wage Rate	Total Annualized Cost of Respondent Burdenb
Individuals/ Householdc	Program Non-participants	Cognitive Test - Household Survey	_	9	9	1	9	0.75	6.8	0	0	0	0.000	0.0	6.8	$7.25	$48.94
		Cognitive Test - Household In-Depth Interview	_	3	3	1	3	0.500	1.5	0	0	0	0.000	0.0	1.5	$7.25	$10.88
	Program Participants	Household Survey Recruitment Letter	T1 (T2)	6,424	4,818	1	4,818	0.083	399.9	1,606	1	1,606	0.083	133.3	533.2	$7.25	$3,865.64
		Household Survey Brochure	T3 (T4)	6,424	4,818	1	4,818	0.050	240.9	1,606	1	1,606	0.050	80.3	321.2	$7.25	$2,328.70
		Household Survey Recruitment Contact Guide	T5 (T6)	6,424	4,818	1	4,818	0.167	804.6	1,606	1	1,606	0.050	80.3	884.9	$7.25	$6,415.57
		Household Survey Appointment Reminder Letter	D1 (D2)	4,818	4,818	1	4,818	0.050	240.9	0	1	0	0.000	0.0	240.9	$7.25	$1,746.53
		Household Survey Income Worksheet	D3 (D4)	4,818	4,818	1	4,818	0.417	2,007.5	0	1	0	0.000	0.0	2,007.5	$7.25	$14,554.38
		Household Survey Consent Form	I1 (I2)	4,818	4,818	1	4,818	0.083	401.5	0	1	0	0.000	0.0	401.5	$7.25	$2,910.88
		Household Survey	D5 (D6)	4,818	4,818	1	4,818	0.750	3,613.5	0	1	0	0.000	0.0	3,613.5	$7.25	$26,197.88
		Household Survey Income Source Show Card	D7 (D8)	4,818	4,818	1	4,818	0.033	160.6	0	1	0	0.000	0.0	160.6	$7.25	$1,164.35
		Household Survey Incentives Received Form	D9 (D10)	4,818	4,818	1	4,818	0.033	160.6	0	1	0	0.000	0.0	160.6	$7.25	$1,164.35
		Household Interview Recruitment Contact Guide	T7 (T8)	60	60	1	60	0.333	20.0	0	1	0	0.000	0.0	20.0	$7.25	$145.00
		Household Interview Appointment Reminder Letter	D11 (D12)	60	60	1	60	0.083	5.0	0	1	0	0.000	0.0	5.0	$7.25	$36.25
		Household Interview (includes Consent)	D13 (D14)	60	60	1	60	0.750	45.0	0	1	0	0.000	0.0	45.0	$7.25	$326.25
		Household Interview Incentives Received Form	D15 (D16)	60	60	1	60	0.033	2.0	0	1	0	0.000	0.0	2.0	$7.25	$14.50
Individuals/ Household Sub-Total				6,433	4,827	9.04	43,614	0.186	8,110.3	1,606	3.00	4,818	0.061	293.9	8404.15		$60,930.07
State Child Nutrition Agency	State Directord	Template E-Letter from FNS Regional Liaison to State CN Director	O2	44	44	1	44	0.250	11.0	0	0	0	0.000	0.0	11.0	$43.82	$482.02
		State Follow Up Contact Guide	O3	44	44	1	44	0.250	11.0	0	0	0	0.000	0.0	11.0	$43.82	$482.02
	Data Managerf	State Meal Claim Request	B14	44	44	1	44	4.000	176.0	0	0	0	0.000	0.0	176.0	$35.97	$6,330.72
School Food Authority (SFA)	Program Non-participantsf	Cognitive Test - SFA Director Survey	_	9	9	1	9	1.000	9.0	0	0	0	0.000	0.0	9.0	$39.34	$354.06
		Cognitive Test - SFA Director In-Depth Interview	_	3	3	1	3	0.917	2.8	0	0	0	0.000	0.0	2.8	$39.34	$108.19
		SFA Sample Notification E-Letter from State Child Nutrition Director to SFA Director	O2	336	336	1	336	0.083	28.0	0	0	0	0.000	0.0	28.0	$39.34	$1,101.52
	SFA Directorg	SFA Study Notification and School Data Verification E-Letter	O4	336	275	1	275	3.000	825.0	61	1	62	0.500	31.0	856.0	$39.34	$33,675.04
		APEC III Fact Sheet (for SFAs and Schools)	O10	336	275	1	275	0.083	22.9	61	1	62	0.083	5.2	28.1	$39.34	$1,104.80
		SFA Follow Up Contact Guide (Study Notification and School Data Verification)	O5	336	275	1	275	0.250	68.8	61	1	62	0.250	15.5	84.3	$39.34	$3,314.40
		SFA Automated Email-Receipt of Verification of School Data	O6	275	275	1	275	0.017	4.6	0	0	0	0.000	0.0	4.6	$39.34	$180.31
		SFA Confirmation and Next Steps Email	O7	275	275	1	275	0.083	22.9	0	0	0	0.000	0.0	22.9	$39.34	$901.54
		SFA School Sample Notification E-Letter	O8	275	275	1	275	0.250	68.8	0	0	0	0.000	0.0	68.8	$39.34	$2,704.63
School Food Authority (SFA), continued	SFA Directorg	SFA Pre-visit Interview	B5	275	275	1	275	0.333	91.7	0	0	0	0.000	0.0	91.7	$39.34	$3,606.17
		SFA Director Survey (web-based, includes Consent)	B11	275	275	1	275	0.750	206.3	0	0	0	0.000	0.0	206.3	$39.34	$8,113.88
		SFA Director Interview (by Phone, includes Consent)	B12	60	60	1	60	0.750	45.0	0	0	0	0.000	0.0	45.0	$39.34	$1,770.30
	SFA Staff f	SFA Request for E-Records (Non-CEP Schools for Household Sampling OR CEP Schools for ISP Data Abstraction)	B1 OR B3	275	275	1	275	0.500	137.5	0	0	0	0.000	0.0	137.5	$39.34	$5,409.25
		SFA Reminder for E-Records (Non-CEP Schools for Houshold Sampling OR CEP Schools for ISP Data Abstraction)	B2 OR B4	275	275	1	275	0.333	91.7	0	0	0	0.000	0.0	91.7	$39.34	$3,606.17
		SFA Data Collection Visit Reminder Email	B6	275	275	1	275	0.050	13.8	0	0	0	0.000	0.0	13.8	$39.34	$540.93
		Application Data Abstraction Form - Phase 1	B7	275	275	1	275	1.000	275.0	0	0	0	0.000	0.0	275.0	$39.34	$10,818.50
		Round 2 & 3 Application Data Abstraction Scheduling Email	B8	275	275	1	275	0.167	45.8	0	0	0	0.000	0.0	45.8	$39.34	$1,803.08
		Application Data Abstraction Form - Phase 2 (if applicable)	B7	275	275	1	275	1.000	275.0	0	0	0	0.000	0.0	275.0	$39.34	$10,818.50
		Round 2 & 3 Application Data Abstraction Scheduling Email (if applicable)	B8	275	275	1	275	0.167	45.8	0	0	0	0.000	0.0	45.8	$39.34	$1,803.08
		Application Data Abstraction Form - Phase 3 (if applicable)	B7	275	275	1	275	1.000	275.0	0	0	0	0.000	0.0	275.0	$39.34	$10,818.50
	Data Managere	SFA Reimbursement Claim Verification Form OR SFA Reimbursement Consolidation and Claim Verification Form	B9 OR B10	275	275	1	275	0.500	137.5	0	0	0	0.000	0.0	137.5	$35.17	$4,835.88
		SFA Meal Participation Data Request	B13	275	275	1	275	2.000	550.0	0	0	0	0.000	0.0	550.0	$35.17	$19,343.50
		Notification Letter from SFA to Sampled Schools	O8	782	782	1	782	0.083	65.2	0	0	0	0.000	0.0	65.2	$39.34	$2,563.66
Schools	School Principalf	School Study Notification E-Letter	O9	782	625	1	625	0.083	52.1	157	1	157	0.333	52.3	104.4	$39.34	$4,107.75
		APEC III Fact Sheet (for SFAs and Schools)	O10	782	625	1	625	0.083	52.1	157	1	157	0.083	13.1	65.2	$39.34	$2,563.66
		School Pre-visit Interview	C1	625	625	1	625	0.333	208.3	0	0	0	0.000	0.0	208.3	$39.34	$8,195.83
	School Staff f	School Data Collection Visit Reminder Email	C2	625	625	1	625	0.050	31.3	0	0	0	0.000	0.0	31.3	$39.34	$1,229.38
		School Meal Count Verification Form	C6	625	625	1	625	0.500	312.5	0	0	0	0.000	0.0	312.5	$39.34	$12,293.75
	Program Non-participantsg	Cognitive Test - Cafeteria Manager In-Depth Interview	_	2	2	1	2	0.750	1.5	0	0	0	0.000	0.0	1.5	$29.97	$44.96
	Cafeteria Managerh	Meal Transaction Observation Form	C3	625	625	1	625	0.500	312.5	0	0	0	0.000	0.0	312.5	$29.97	$9,365.63
		Cafeteria Manager Interview (includes Consent)	C5	60	60	1	60	0.750	45.0	0	0	0	0.000	0.0	45.0	$29.97	$1,348.65
State/Local/Tribal Government Sub-Total				3,019	2,801	3.60	10,084	0.448	4,521.1	218	2.29	500	0.234	117.1	4,638.17		$175,740.21
	TOTAL			9,452	7,628	7.04	53,698	0.235	12,631.3	1,824	2.92	5,318	0.077	411.0	13,042		$236,670.28
Notes:
The Official Study Notification Letters sent to the FNS Regions and the FNS Regional Liaisons (Exhibits O1-2 and O1-3 within Appendix O1) from FNS Headquarters are not included with the Burden Table. Additionally, these letters do not include the OMB Disclosure/PRA Burden Statement as they are sent from FNS Headquarters to FNS Regions/Regional Liaisons.
Appendix C4 is not included in the burden table because it is an example of information the data collector will enter in a sampling program based on data previously obtained. This is an administrative process, with no burden to a respondent.
[Row 4] The individual/Household sub-total does not include the in-depth interview respondents (n=3) because those respondents were a subset of the nine respondents that completed the household survey cognitive test. These are already
included in the total number of household respondents.
[Rows 19 - 20, Rows 24 - 30, and Rows 44-46] Instruments highlighted in yellow reflect materials used for the Sample Frame Development (Pre Data Collection Activities).
[Row 19] The total burden for the State for Appendix O2 is 15 minutes. This includes 5 minutes to review the letter, 5 minutes to complete/send contact information using a spreadsheet, and 5 minutes to review/edit/send a letter to to their SFAs
using a template provided.
[Row 24] This refers to the template letter included as an attachment with Appendix O2 that the State Child Nutrition Director has the option to use to notify the SFAs.
[Row 27] The total burden for Appendix O5 is 15 minutes. This time is for discussion of questions and the explanation of the use of the Excel template file if the SFA cannot use the Web Portal (Appendix O4). The burden to complete the information
using the Excel template file (if preferred by SFA) is included in the time to complete Web Portal (Appendix O4) as it is one or the other, not both.
[Row 30] The total burden to the SFA for Appendix O8 is 15 minutes. This includes 5 minutes to review the letter and 10 minutes to review/edit/send a letter to their schools using the template provided.
[Row 44] This refers to the template letter included as an attachment with Appendix O8 that the SFA Director has the option to use to notify the schools.
[Row 53] The State/Local/Tribal Government sub-total inlcudes 11 respondents (not 12) for the SFA Director survey (row 22) and in-depth interview (row 23) cognitive pretest because one respondent completed both the survey and in-depth interview.
Footnotes:
a Numbers are always rounded up to the next whole number (for example, 473.68 becomes 474).
b Costs are rounded up to the next whole cent.
c Federal minimum wage for household level: http://www.dol.gov/whd/minimumwage.htm
d Job category "Management Occupations;" code #11-9030 "Education Administrators" industry "State Government" for state level mean hourly wage of $43.82.
e Job category "Computer and Mathematical Occupations;" code #15-1141 "Database Administrators" mean hourly wage of $35.17 for Data Managers at SFA level.
f Job category "Computer and Mathematical Occupations, " code #15-1141 "Database Administrator" mean hourly wage of $35.97 for Data Managers at State level.
g Job category "Management Occupations;" code #11-9039 "Education Administrators, All Other;" industry "Educational Services (including private, state and local government schools)" mean hourly wage of $39.34 for SFA Director or School Staff (principal or administrator).
h Job category "Management Occupations;" code #11-9051 "Food Service Manager;" industry "Educational Services (including private, state, and local government schools)" mean hourly wage of $29.97 for Cafeteria Manager.