Information Collection

State SNAP Agencies

IC 214459 under ICR 201411-0584-004 · OMB 0584-0602.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0602 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
ATTACHMENT 17_List of Adminstrative Data Elements.docx	Other-ATTACHMENT 17_List of Adminstr
Attachment S - FNS-583 Used to Collect Other Admin Data.pdf FNS 583	IC Document

IC Title:

State SNAP Agencies

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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-ATTACHMENT 17_List of Adminstrative Data Elements			ATTACHMENT 17_List of Adminstrative Data Elements.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: 25

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	30	30
Annual IC Time Burden (Hours)	305	305
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
FNS 583	Attachment S - FNS-583 Used to Collect Other Admin Data.pdf	01/23/2015

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