Food Stamp Program Application, Form FNS-252 and Form FNS-252-2

Forms and Documents

Document Name	Status

No forms / supporting documents in this ICR. Check IC Document Collections.

IC Document Collections

IC ID	Document Title	Status
2886	Food Stamp Program Application, Form FNS-252 and Form FNS-252-2 Form	Migrated

ICR Details

OMB Control No: 0584-0008	ICR Reference No: 200305-0584-004
Status: Historical Active	Previous ICR Reference No: 200206-0584-002
Agency/Subagency: USDA/FNS	Agency Tracking No:
Title: Food Stamp Program Application, Form FNS-252 and Form FNS-252-2
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 06/27/2003
	Date Received in OIRA: 05/09/2003
Terms of Clearance: The current form only is approved for 1 year. The new form is not approved at this time. FNS has agreed, as per the previous terms of clearance, to conduct testing of the new form prior to submitting the new form for OMB approval. This testing should include focus group or individual testing, as well as possibly including online consultation, on only the 252 revised form, but not on the revised meal service application or new addendum for corporations. Although FNS is not required to conduct testing on these other two forms, FNS shall work to ensure that the forms are vetted with the community and are as user friendly as possible. FNS shall immediately initiate procedures to clear the focus group testing under the PRA, in order to allow for sufficient time to revise the form if necessary prior to use. After revisions (if any), FNS shall submit the new 252 form to OMB for approval; OMB will waive the 60-day public comment period for the review. FNS shall submit the information collection request at the same time that they submit the 30-day Federal Register notice for publication. If there will be a time lag between approval of the new form and use of the new form, FNS will submit both forms for approval in order to allow for a seamless transition.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2004	07/31/2004	06/30/2003
Responses	34,888	0	40,190
Time Burden (Hours)	7,309	0	9,447
Cost Burden (Dollars)	0	0	0

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Abstract: The information collected on these forms are used by the field office to make a determination about a store or meal service's eligibility for the Food Stamp Program.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Food Stamp Program Application, Form FNS-252 and Form FNS-252-2	FNS-252, FNS-252-2

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	34,888	40,190	0	-5,302	0	0
Annual Time Burden (Hours)	7,309	9,447	0	-2,138	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 05/09/2003

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