Food Back Pack

Uniform Grant Application for Non-Entitlement Discretionary Grants

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0512 can be found here:

Documents and Forms

Document Name Document Type
Form SF LLL Food Back Pack Form and Instruction
SF LLL DISCLOSURE OF LOBBYING ACTIVITIES SF-LLL.pdf www.grants.gov Form and Instruction
SF 425 Federal Financial Report SF-425.pdf www.grants.gov Form
SF 425A Federal Financial Report SF-425A.pdf www.grants.gov Form
Solicitation_for_State_Agencies_-_2011_SFSP_demos_10 5 10 no highlights.doc Request for Applications (RFA) IC Document
Request of Approval to Add Grant to OMB Docket Memo 9.16.2010.doc Memo IC Document
Home Delivery and Food Backpack SS Justification 10 5 10.doc Supporting Statement IC Document
SF-424.pdf SF 424 IC Document
SF-424A.pdf SF 424A IC Document
SF-424B.pdf SF 424B IC Document
AD1047-F-01-92.pdf AD1047 IC Document
AD-1052.pdf AD 1052 IC Document

Information Collection (IC) Details

IC Title:	Food Back Pack	Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SF LLL	DISCLOSURE OF LOBBYING ACTIVITIES	SF-LLL.pdf	http://www.grants.gov	Yes	Yes	Fillable Fileable Signable
Form	SF 425	Federal Financial Report	SF-425.pdf	http://www.grants.gov	Yes	Yes	Fillable Fileable Signable
Form	SF 425A	Federal Financial Report	SF-425A.pdf	http://www.grants.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: 30	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 50 %

	Requested	Previously Approved
Annual Number of Responses for this IC	58	58
Annual IC Time Burden (Hours)	3,301	3,301
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Request for Applications (RFA)	Solicitation_for_State_Agencies_-_2011_SFSP_demos_10 5 10 no highlights.doc	10/06/2010
Memo	Request of Approval to Add Grant to OMB Docket Memo 9.16.2010.doc	09/27/2010
Supporting Statement	Home Delivery and Food Backpack SS Justification 10 5 10.doc	10/06/2010
SF 424	SF-424.pdf	09/27/2010
SF 424A	SF-424A.pdf	09/27/2010
SF 424B	SF-424B.pdf	09/27/2010
AD1047	AD1047-F-01-92.pdf	09/27/2010
AD 1052	AD-1052.pdf	09/27/2010

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