FNS-380, Worksheet for the Supplemental Nutrition Assistance Program Quality Control Reviews

Forms and Documents

Document Name	Status
Form FNS-380 SNAP Quality Control Reviews - State Burden Form and Instruction	Modified
FNS380 SS Part A OMB 0584-0074 final 4-11-13.doc Supporting Statement A	2013-04-11
3. FNS380 SS OMB 0584-0074 SS part B 2-25-13.doc Supporting Statement B	2013-03-21

IC Document Collections

IC ID	Document Title	Status
45873	SNAP Quality Control Review - Household Burden	Modified
2971	SNAP Quality Control Reviews - State Burden Form and Instruction	Modified

ICR Details

OMB Control No: 0584-0074	ICR Reference No: 201303-0584-001
Status: Historical Active	Previous ICR Reference No: 201002-0584-001
Agency/Subagency: USDA/FNS	Agency Tracking No:
Title: FNS-380, Worksheet for the Supplemental Nutrition Assistance Program Quality Control Reviews
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/22/2013
	Date Received in OIRA: 04/18/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2016	36 Months From Approved	05/31/2013
Responses	155,877	0	112,130
Time Burden (Hours)	489,641	0	528,333
Cost Burden (Dollars)	0	0	0

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Abstract: This form provides a systematic means of aiding the State's Quality Control Reviewer in analyzing the case record, planning and doing field investigation and gathering, comparing, analyzing and evaluating data.

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Authorizing Statute(s): PL: Pub.L. 108 - 269 16 Name of Law: Food Stamp Act of 1977
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 3390	01/16/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 72	04/15/2013
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
SNAP Quality Control Reviews - State Burden	FNS-380, FNS-380	Worksheet for SNAP Quality Control Reviews ,   Worksheet for SNAP Quality Control Reviews (Web-based)
SNAP Quality Control Review - Household Burden

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	155,877	112,130	0	0	43,747	0
Annual Time Burden (Hours)	489,641	528,333	0	0	-38,692	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a revision of a currently approved information collection. The proposed OMB inventory for the reporting and recordkeeping burdens associated with this collection is approximately 489,640.8 annual burden hours. The difference between the old burden of 528,333 and the new burden of 489,640.8 is a decrease of 38,692 hours. This also resulted in a -4,106 decrease in the number of overall completed case reviews of household participants from 56,065 in FY 2007 to 51,959 in FY for reporting. There is an additional adjustment. During the previous submission, annual responses for recordkeeping were not taken into account when entering this request into ROCIS. Subsequently, there is an increase of 47,853 responses for recordkeeping. There is an additional adjustment. During the previous submission, annual responses for recordkeeping were not taken into account when entering this request into ROCIS. The total annual response for recordkeeping for this collection is 51,959 subtracted from the 56,065 current annual responses for recordkeeping reflects a decrease of -4,106. Subsequently, there is an increase of 47,853 responses for recordkeeping. .

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Annual Cost to Federal Government: $5,282,065

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 04/18/2013

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