MODEL FOOD STAMPS, PERIODIC REPORTING, NOTICE OF LATE INCOMPLETE REPORTING, ADEQUATE NOTICE, SPONSORED ALIENS, DUPLICATION PARTICIPATION, AND DISQUALIFIED RECIPIENT REPORT
ICR 199112-0584-002
OMB: 0584-0064
Federal Form Document
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0584-0064 can be found here:
MODEL FOOD STAMPS, PERIODIC
REPORTING, NOTICE OF LATE INCOMPLETE REPORTING, ADEQUATE NOTICE,
SPONSORED ALIENS, DUPLICATION PARTICIPATION, AND DISQUALIFIED
RECIPIENT REPORT
Reinstatement with change of a previously approved collection
THE INFORMATION COLLECTION IS
NECESSARY IN ORDER TO COMPLY WITH STATUTORY PROVISIONS RELATED TO
THE CERTIFICATION OF APPLICANT HOUSEHOLDS AND THE CONTINUED
ELIGIBILITY OF SUCH HOUSEHOLDS.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.