SNAP Forms: Applications, Periodic Reporting, Notices

Forms and Documents

Document Name	Status
Appendix A_0584-0064 Baseline Revision - Burden Narrative.docx Supplementary Document	2015-11-19
Appendix B_OMB 0584-0064 Baseline Revision Burden Table.xlsx Supplementary Document	2015-11-19
OMB 0584-0064 Baseline Revision Supporting Statement_10-22-15.docx Supporting Statement A	2016-02-01

IC Document Collections

IC ID	Document Title	Status
2960	State: Applications, Periodic Reporting, Notices	Modified
182154	State & Local Agency Recordkeeping	Modified
182153	Household/Individual: Application & Periodic Reporting	Modified

ICR Details

OMB Control No: 0584-0064	ICR Reference No: 201511-0584-006
Status: Historical Active	Previous ICR Reference No: 201303-0584-003
Agency/Subagency: USDA/FNS	Agency Tracking No:
Title: SNAP Forms: Applications, Periodic Reporting, Notices
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: 05/09/2016
	Date Received in OIRA: 02/03/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2019	36 Months From Approved	05/31/2016
Responses	658,539,828	0	294,426,292
Time Burden (Hours)	118,221,440	0	24,897,947
Cost Burden (Dollars)	0	0	0

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Abstract: Information collected is used to determine eligibility and participation in the Supplemental Nutrition Assistance Program (SNAP). Certifications and periodic reporting are to verify current eligibility.

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Authorizing Statute(s): PL: Pub.L. 108 - 267 3, 5, 11 Name of Law: The Food Stamp Act of 1977
   PL: Pub.L. 107 - 171 Title IV Subtitle A Name of Law: FSRIA 2002
   PL: Pub.L. 104 - 193 Title IV Name of Law: PRWORA
   PL: Pub.L. 104 - 208 Title I Name of Law: Omnibus Consoidated Appropriations Act
   PL: Pub.L. 105 - 185 Title IV Name of Law: Ag Research, Extension, & Education Reform Act of 1998
   US Code: 33 USC 2701(31) Name of Law: Oil Pollution Act of 1990 (OPA90)
  

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:
	80 FR 27885	05/15/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 3776	01/22/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

IC Title	Form No.	Form Name
Household/Individual: Application & Periodic Reporting
State: Applications, Periodic Reporting, Notices
State & Local Agency Recordkeeping

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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	658,539,828	294,426,292	0	364,113,536	0	0
Annual Time Burden (Hours)	118,221,440	24,897,947	0	93,323,493	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: Changes in burden resulted from adjustments to the burden baseline, to account for activities not previously captured under collection package OMB No. 0584-0064, the update of household participation to FY 2011 - FY 2012 data, and also the inclusion of the burden hours associated with the households’ travel time to the local office for the initial and recertification interviews. These adjustments will result in an increase of 93,323,493.490 hours, once approved by OMB.

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Annual Cost to Federal Government: $356,365,831

Does this IC contain surveys, censuses, or employ statistical methods? No

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: 02/03/2016

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