Zero Income (SA)

Generic Clearance to Conduct Formative Research

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0524 can be found here:

Documents and Forms

Document Name Document Type
Attachment C - Recruitment Letter to states.docx Other-Recruitment Letter to states
Attachment D - Instructions to States.docx Instruction
Attachment F - Recruitment script for States2.docx Other-Recruitment script for States2
Zero Income Generic Clearance 1-11-12.docx Zero Income Generic Clearance Justification IC Document

Information Collection (IC) Details

IC Title:	Zero Income (SA)	Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-Recruitment Letter to states	Attachment C - Recruitment Letter to states.docx	No	Paper Only
Instruction	Attachment D - Instructions to States.docx	No	Paper Only
Other-Recruitment script for States2	Attachment F - Recruitment script for States2.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: 12	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	12	12
Annual IC Time Burden (Hours)	20	20
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Zero Income Generic Clearance Justification	Zero Income Generic Clearance 1-11-12.docx	01/13/2012

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