Information Collection

State Agencies (SNAP Staff)

IC 202642 under ICR 201401-0584-001 · OMB 0584-0582.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Ap I_Site Visit and Interview Protocol.docx	Other-Ap I Site Visits and Interview
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	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

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-Ap H_Time Use Data Collection Protocol			Ap H_Time Use Data Collection Protocol.docx		No		Paper Only
Other-Ap I Site Visits and Interview Protocol			Ap I_Site Visit and Interview Protocol.docx		No		Paper Only

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 90

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	90	90
Annual IC Time Burden (Hours)	192	192
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	Ap C1_Letters to SNAP Directors_Letter to County and Local SNAP Office Directors-NC&OR.docx	08/20/2012
Appendix C2 - Letters to SNAP Directors-Letter to County and Local SNAP Office Directors-UT	Ap C2_Letters to SNAP Directors_Letter to County and Local SNAP Office Directors-UT.docx	08/20/2012
Appendix C3 - Letters to SNAP Directors-Letter to Partner CBO Point of Contact - All States	Ap C3_Letters to SNAP Directors_Letter to Partner CBO Point of Contact - All States.docx	08/20/2012
Appendix I2- Staff Interview Consent Form	Ap I2_Staff Interview Consent Form.docx	08/20/2012

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