Attachment 3 Burden Table

Appendix 3 Burden Table - SNAP-Ed Toolkit Intervention Submission Form & Scoring Tool.xlsx

SNAP-Ed Toolkit Submission Form and Scoring Tool

Attachment 3 Burden Table

OMB: 0584-0639

Document [xlsx]
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Respondent Category Type of Respondents Instruments Form Number of Respondents Frequency of Response Total Annual Responses Hours per Response Annual Burden (Hours) Hourly Wage Rate Total Annualized Cost of Respondent Burden
State/Local/Tribal Government SNAP-Ed State and Implementing Agency Dietitians & Nutritionists Intervention Submission Form FNS-886 39 1 39 5 195.0 $28.69 $5,594.55
Scoring Tool FNS-885 22 2 44 5 220.0 $28.69 $6,311.80
Scoring Tool (Training) FNS-885 22 1 22 1 22.0 $28.69 $631.18
SUBTOTAL: State/Local/Tribal Government


83 1.2651 105 4.1619 437.0
$12,537.53
Business, Non-Profit Biological Sciences Teachers, Postsecondary Intervention Submission Form FNS-886 15 1 15 5 75.0 $43.47 $3,260.25
Intervention Submission Form (Pretesting) FNS-886 2 1 2 5 10.0 $43.47 $434.70
Scoring Tool FNS-885 7 2 14 5 70.0 $43.47 $3,042.90
Scoring Tool (Pretesting) FNS-885 2 1 2 5 10.0 $43.47 $434.70
Scoring Tool (Training) FNS-885 7 1 7 1 7.0 $43.47 $304.29
SUBTOTAL: Business, Non-Profit


33 1.2121 40 4.3000 172.0
$7,476.84
Business, Profit Dietitians and Nutritionists Intervention Submission Form FNS-886 3 1 3 5 15.0 $28.69 $430.35
Scoring Tool FNS-885 4 2 8 5 40.0 $28.69 $1,147.60
Scoring Tool (Training) FNS-885 4 1 4 1 4.0 $28.69 $114.76
SUBTOTAL: Business, Profit


11 1.3636 15 3.9333 59.0 $28.69 $1,692.71
TOTAL


127 1.2598 160 4.1750 668.0
$21,161.97


































































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