Burden Table

INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and
recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OM]B-83-1:
cols. (D) &/or (I) = 13a (regpondent is only counted once); cols. F & I - 13b; cols. H & K- 13c.

Page 1 of 1
OMBNO.

TITLE OF INFORMATION COLLECTION DOCUMENT
Food Stamp Nutrition Connection Recipe Submission and Review
Form

0518-0043
DATE PREPARED

ANNUAL BURDEN

IDENTIFICATION OF REPORTING OR RECORDKEI~PING R~QUIREMENT

REPORTS

SECTION OF

DESCRtPTION

RESPONDENTS

REGS

RECORDS

NOOF

TOTALANNUAL

RESPONSES

R~SPON~ES

PER

(Col. D x E)

HOURS

TOTAL

NOOF

ANNUAL

pER

HOURS

RECORD

HOURSPER

(COI. FxG)

KEEPERS

RECORO-

RESPONSE

(Col, lxJ)

KEEPER

(c)

(B)

(~

(K)

(H)

Individual or Households

3one

5C

1.000(

50.00

0.t200

6.00

Private Sector

None

5(

1.0000

50.00

0.1200

6.00

State, Local or Tribal Government

None

i50

1.0000

150.00

0.1200

18.00

SUBTOTAL

250.00

Prepared by user 5/8/2008

30.0(~

Page 1