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Businesses (Vendors)
Evaluation of the Direct Certification with Medicaid for Free and Reduced-Price (DCM-F/RP) Meals Demonstration
OMB: 0584-0630
IC ID: 227123
OMB.report
USDA/FNS
OMB 0584-0630
ICR 201904-0584-001
IC 227123
( )
Documents and Forms
Document Name
Document Type
A3a DCM-FRP CN Site Visit Protocol.docx
Other-Appendix A-3.a Detailed Site V
A3b DCM-FRP Medicaid Site Visit Protocol.docx
Other-Appendix A-3.b Detailed Site V
A2d Vendor Phone Interview Email.docx
Appendix A-2.d Vendor Telephone Interview Email
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Businesses (Vendors)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-Appendix A-3.a Detailed Site Visit Interview Protocol: State Child Nutrition Agency Staff
A3a DCM-FRP CN Site Visit Protocol.docx
No
Paper Only
Other-Appendix A-3.b Detailed Site Visit Interview Protocol: State Medicaid Agency Staff
A3b DCM-FRP Medicaid Site Visit Protocol.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
Food and Nutrition Assistance
Privacy Act System of Records
Title:
FNS-8 USDA/FNS Studies and Reports
FR Citation:
56 FR 19078
Number of Respondents:
4
Number of Respondents for Small Entity:
2
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
6
0
0
0
0
6
Annual IC Time Burden (Hours)
4
0
0
0
0
4
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Appendix A-2.d Vendor Telephone Interview Email
A2d Vendor Phone Interview Email.docx
06/20/2017
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.