Supplemental Nutrition Assistance Program Pre-Screening Tool

SNAProgram Pre-Screening Tool

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Public Burden Statement Screen Shot 8-12-08.doc www.snap-step1.usda.gov Other-Website Screenshot

Information Collection (IC) Details

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:

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 %

	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

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.