Supplemental Nutrition Assistance Program Pre-Screening Tool

SNAProgram Pre-Screening Tool

Documents and Forms

Document Name Document Type
Screen shots V3 English 1-21-15.docx www.snap-step1.usda.gov Other-Website English Screenshot
SNAP Pre-Screening Tool - Spanish 1-21-15.pdf www.snap-step1.usda.gov/fns/index.jsp Other-Website Spanish Screenshots

Information Collection (IC) Details

IC Title:	Supplemental Nutrition Assistance Program Pre-Screening Tool	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 7 CFR 243.9 Section 5

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Website English Screenshot			Screen shots V3 English 1-21-15.docx	www.snap-step1.usda.gov	Yes	Yes	Fillable Fileable Signable
Other-Website Spanish Screenshots			SNAP Pre-Screening Tool - Spanish 1-21-15.pdf	http://www.snap-step1.usda.gov/fns/index.jsp	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title: USDA/FNS-10 Persons Doing Business with FNS	FR Citation: 65 FR 17251

Number of Respondents: 402,534	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	402,534	6,534	396,000
Annual IC Time Burden (Hours)	67,223	1,091	66,132
Annual IC Cost Burden (Dollars)	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.