Information Collection

State Agencies (SNAP Staff)

IC 202642 under ICR 201206-0584-002 · OMB 0584-0582.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0582 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Ap I_Site Visit and Interview Protocol.docx	Other-Ap I Site Visits and Interview
Ap H_Time Use Data Collection Protocol.docx	Other-Ap H_Time Use Data Collection
Ap C1_Letters to SNAP Directors_Letter to County and Local SNAP Office Directors-NC&OR.docx Appendix C1 - Letters to SNAP Directors - Letter to County and Local SNAP Office Directors-NC&OR	IC Document
Ap C2_Letters to SNAP Directors_Letter to County and Local SNAP Office Directors-UT.docx Appendix C2 - Letters to SNAP Directors-Letter to County and Local SNAP Office Directors-UT	IC Document
Ap C3_Letters to SNAP Directors_Letter to Partner CBO Point of Contact - All States.docx Appendix C3 - Letters to SNAP Directors-Letter to Partner CBO Point of Contact - All States	IC Document
Ap I2_Staff Interview Consent Form.docx Appendix I2- Staff Interview Consent Form	IC Document

IC Title:

State Agencies (SNAP Staff)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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-Ap I Site Visits and Interview Protocol			Ap I_Site Visit and Interview Protocol.docx		No		Paper Only
Other-Ap H_Time Use Data Collection Protocol			Ap H_Time Use Data Collection Protocol.docx		No		Paper Only

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 90

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
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	180	180
Annual IC Time Burden (Hours)	270	270
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix C1 - Letters to SNAP Directors - Letter to County and Local SNAP Office Directors-NC&OR	Ap C1_Letters to SNAP Directors_Letter to County and Local SNAP Office Directors-NC&OR.docx	08/20/2012
Appendix C2 - Letters to SNAP Directors-Letter to County and Local SNAP Office Directors-UT	Ap C2_Letters to SNAP Directors_Letter to County and Local SNAP Office Directors-UT.docx	08/20/2012
Appendix C3 - Letters to SNAP Directors-Letter to Partner CBO Point of Contact - All States	Ap C3_Letters to SNAP Directors_Letter to Partner CBO Point of Contact - All States.docx	08/20/2012
Appendix I2- Staff Interview Consent Form	Ap I2_Staff Interview Consent Form.docx	08/20/2012

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