Information Collection

Self-Evaluation Data

IC 203884 under ICR 201208-0584-010 · OMB 0584-0571.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Unwritten Information Collection Instrument Placeholder.doc	Other-Self Evaluation Data

IC Title:

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-Self Evaluation Data			Unwritten Information Collection Instrument Placeholder.doc		No		Paper Only

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title: FNS Studies and Reports

FR Citation: 56 FR 19078

Number of Respondents: 80

Number of Respondents for Small Entity: 8

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	80	80
Annual IC Time Burden (Hours)	160	160
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.