Information Collection

Business (CBO Staff)

IC 202643 under ICR 201210-0584-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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-Appendix I- Site Visit and Int
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 (New).	IC Document

IC Title:

Business (CBO Staff)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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-Appendix I- Site Visit and Interview Protocol					No		Paper Only
Other-Ap H_Time Use Data Collection Protocol					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: Private Sector

Private Sector: 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	12	12
Annual IC Time Burden (Hours)	18	18
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		08/20/2012
Appendix C2 - Letters to SNAP Directors-Letter to County and Local SNAP Office Directors-UT		08/20/2012
Appendix C3 - Letters to SNAP Directors-Letter to Partner CBO Point of Contact - All States		08/20/2012
Appendix I2 - Staff Interview Consent Form (New).		08/20/2012

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

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