Food Stamp Forms: Applications, Periodic Reporting, Notices

Forms and Documents

Document Name	Status
Burden_Summary_0584-0064 2-23-2010 revised.xls Supplementary Document	2010-02-23
Attachment G - Burden Narrative Associated with 0584-0064 1.11.10.doc Supplementary Document	2010-01-11
Supporting_Statement_2-22-2010.docx Supporting Statement A	2010-02-25

IC Document Collections

IC ID	Document Title	Status
2960	State: Applications, Periodic Reporting, Notices	Modified
182154	Local Agencies Recordkeeping	Modified
182153	Household/Individual: Application & Periodic Reporting	Modified

ICR Details

OMB Control No: 0584-0064	ICR Reference No: 200811-0584-001
Status: Historical Active	Previous ICR Reference No: 200709-0584-004
Agency/Subagency: USDA/FNS	Agency Tracking No: E&C Final Rule
Title: Food Stamp Forms: Applications, Periodic Reporting, Notices
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/26/2010
	Date Received in OIRA: 02/25/2010
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2013	36 Months From Approved	12/31/2010
Responses	294,426,292	0	286,545,662
Time Burden (Hours)	24,893,623	0	23,642,768
Cost Burden (Dollars)	0	0	0

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Abstract: Information collected is used to determine eligibility and participation in the food stamp program. Certifications and periodic reporting are to verify current eligibility.

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Authorizing Statute(s): PL: Pub.L. 104 - 208 Title I Name of Law: Omnibus Consoidated Appropriations Act
   PL: Pub.L. 105 - 185 Title IV Name of Law: Ag Research, Extension, & Education Reform Act of 1998
   PL: Pub.L. 108 - 267 3, 5, 11 Name of Law: The Food Stamp Act of 1977
   PL: Pub.L. 107 - 171 Title IV Subtitle A Name of Law: FSRIA 2002
   PL: Pub.L. 104 - 193 Title IV Name of Law: PRWORA
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0584-AD30	Final or interim final rulemaking	75 FR 19	01/29/2010

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	69 FR 20724	04/16/2004
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 3

IC Title	Form No.	Form Name
Household/Individual: Application & Periodic Reporting
Local Agencies Recordkeeping
State: Applications, Periodic Reporting, Notices

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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	294,426,292	286,545,662	0	7,880,630	0	0
Annual Time Burden (Hours)	24,893,623	23,642,768	0	1,250,855	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to: Changing Regulations

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

Burden Reduction Due to:

Short Statement: This is a revision of a currently approved data collection. The changes in the information collection burden reflect the changes contained in the final rule “Food Stamp Program: Eligibility and Certification Provisions of the Farm Security and Rural Investment Act of 2002” as well as those changes resulting changes in State policy and caseload growth. The current burden for 0584-0064 is 23,642,768 which have increased by 1,250,579 [0584-0496 increased by 236 hours and 0584-0083 increased by 40 hours for a total of 1,250,855 for this request (due to the FSRIA Final Rule)] for a total of 24,893,623 burden hours for 0584-0064.

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Annual Cost to Federal Government: $6,855,727

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)? No

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: 02/25/2010

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