Information Collection

Supplemental Nutrition Assistance Program Pre-Screening Tool

IC 3134 under ICR 201111-0584-005 · OMB 0584-0519.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0519 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Public Burden Statement Screen Shot 8-12-08.doc www.snap-step1.usda.gov	Other-Website Screenshot

IC Title:

Supplemental Nutrition Assistance Program Pre-Screening Tool

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 7 CFR 243.9 Section 5

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-Website Screenshot			Public Burden Statement Screen Shot 8-12-08.doc	www.snap-step1.usda.gov	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 396,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	396,000	132,000	264,000
Annual IC Time Burden (Hours)	66,132	22,132	44,000
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.