FNS-380, Worksheet for the Supplemental Nutrition Assistance Program Quality Control Reviews

Forms and Documents

Document Name	Status
Form FNS-380 SNAP Quality Control Reviews - State Burden Form and Instruction	Modified
e. FNA2008-wAgAct14-pgs 96-102 QCprovisions.pdf Supplementary Document	2016-05-31
OMB 0584-0074 FNS 380 SSA 5-31-2016 w ROCIS calc no mark up.docx Supporting Statement A	2016-05-31
OMB 0584-0074 FNS 380 SS Part B 4-27-16.docx Supporting Statement B	2016-05-25

IC Document Collections

IC ID	Document Title	Status
45873	SNAP Quality Control Review - Household Burden	Modified
2971	SNAP Quality Control Reviews - State Burden Form and Instruction	Modified

ICR Details

OMB Control No: 0584-0074	ICR Reference No: 201602-0584-003
Status: Historical Active	Previous ICR Reference No: 201303-0584-001
Agency/Subagency: USDA/FNS	Agency Tracking No:
Title: FNS-380, Worksheet for the Supplemental Nutrition Assistance Program Quality Control Reviews
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: 09/26/2016
	Date Received in OIRA: 05/31/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2019	36 Months From Approved	09/30/2016
Responses	165,201	0	155,877
Time Burden (Hours)	518,930	0	489,641
Cost Burden (Dollars)	0	0	0

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Abstract: This form provides a systematic means of aiding the State's Quality Control Reviewer in analyzing the case record, planning and doing field investigation and gathering, comparing, analyzing and evaluating data.

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Authorizing Statute(s): PL: Pub.L. 108 - 269 16 Name of Law: Food Stamp Act of 1977
  

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:
	81 FR 10567	03/01/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 33461	05/26/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
SNAP Quality Control Reviews - State Burden	FNS-380	Worksheet for SNAP Quality Control Reviews
SNAP Quality Control Review - Household Burden

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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	165,201	155,877	0	0	9,324	0
Annual Time Burden (Hours)	518,930	489,641	0	0	29,289	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: This is a revision of a currently approved data collection. The current burden inventory is 489,641 burden hours and 155,877 responses. The revised OMB inventory for the reporting and recordkeeping burdens associated with the FNS-380 is approximately 518,930 annual burden hours and 165,203 responses. This program adjustment reflects an increase of approximately 29,289 hours and 9,324 responses. This difference is primarily a result of the increase in the overall active household caseload sample reported where the number of completed reviews went up from 51,959 to 55,067 since our last collection revision.

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Annual Cost to Federal Government: $8,646,940

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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: 05/31/2016

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