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WIC Federal and State Agreement
WIC Federal and State Agreement
OMB: 0584-0332
IC ID: 43553
OMB.report
USDA/FNS
OMB 0584-0332
ICR 201210-0584-005
IC 43553
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0332 can be found here:
2023-07-05 - No material or nonsubstantive change to a currently approved collection
2022-04-15 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form FNS 339
WIC Federal and State Agreement
Form and Instruction
FNS 339 Federal State Supplemental Nutrition Programs Agreement
FNS-339 current form.pdf
www.fns.usda.gov/fns/forms.htm
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
WIC Federal and State Agreement
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
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
FNS 339
Federal State Supplemental Nutrition Programs Agreement
FNS-339 current form.pdf
http://www.fns.usda.gov/fns/forms.htm
Yes
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
Food and Nutrition Assistance
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
142
Number of Respondents for Small Entity:
24
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
142
0
0
-1
0
143
Annual IC Time Burden (Hours)
36
0
0
0
0
36
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.