Information Collection

State Agency (aka Key Informants)

IC 197397 under ICR 201201-0584-008 · OMB 0584-0560.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
I1. Cost Instrument - Short.docx	Other-State Agency Cost Quest.
J._Key_informant_interview_guides_7-20-11.docx	Other-State Agency Interview Guides

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

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-State Agency Cost Quest.			I1. Cost Instrument - Short.docx		No		Paper Only
Other-State Agency Interview Guides			J._Key_informant_interview_guides_7-20-11.docx		Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 8

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	Previously Approved
Annual Number of Responses for this IC	42	42
Annual IC Time Burden (Hours)	9	9
Annual IC Cost Burden (Dollars)	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.