Information Collection

Zero Income (SA)

IC 200310 under ICR 201008-0584-001 · OMB 0584-0524.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0524 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment C - Recruitment Letter to states.docx	Other-Recruitment Letter to states
Attachment D - Instructions to States.docx	Instruction
Attachment F - Recruitment script for States2.docx	Other-Recruitment script for States2
Zero Income Generic Clearance 1-11-12.docx Zero Income Generic Clearance Justification	IC Document

IC Title:

Zero Income (SA)

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-Recruitment Letter to states	Attachment C - Recruitment Letter to states.docx	No	Paper Only
Instruction	Attachment D - Instructions to States.docx	No	Paper Only
Other-Recruitment script for States2	Attachment F - Recruitment script for States2.docx	No	Paper Only

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 12

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	12	12
Annual IC Time Burden (Hours)	20	20
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Zero Income Generic Clearance Justification	Zero Income Generic Clearance 1-11-12.docx	01/13/2012

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.