Information Collection

Annual report of State Revenue Matching

IC 2974 under ICR 201311-0584-007 · OMB 0584-0075.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FNS-13 Annual Report of State Revenue Matching Annual report of State Revenue Matching	Form and Instruction
FNS-13 Annual Report of State Revenue Matching FNS-13 Screenshots and Instruction.pdf fprs.fns.usda.gov	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 7 CFR 210.17

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
Form and Instruction	FNS-13			https://fprs.fns.usda.gov	Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 57

Number of Respondents for Small Entity: 2

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	57	0	57
Annual IC Time Burden (Hours)	456	-4,104	4,560
Annual IC Cost Burden (Dollars)	0	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.

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