Information Collection

Non Response Placeholder

IC 191125 under ICR 201012-0584-001 · OMB 0584-0554.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0554 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
NON-Response Place Holder.doc	Other-Non response Place Holder

IC Title:

Non Response Placeholder

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Non response Place Holder			NON-Response Place Holder.doc		No		Paper Only

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,542

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	2,542	1,487	1,055
Annual IC Time Burden (Hours)	240	-55	295
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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