Information Collection

State SNAP Agencies

IC 214459 under ICR 201512-0584-009 · OMB 0584-0602.

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: 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-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	Previously Approved
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.