Information Collection

State & Local Agency's Requirements

IC 45202 under ICR 201605-0584-006 · OMB 0584-0541.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0541 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix 4 FNS-683a FPRS Screenshots and PBStatement.pdf Appendix 4 FNS-683a SFMNP Annual Financial and Program Data Report FPRS Screenshots	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

State & Local Agency's Requirements

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 7 CFR 249.3(d) 7 CFR 249.4 7 CFR 249.10 (b), (e), (f), and (h) 7 CFR 249.11 7 CFR 249.17(b)(2) 7 CFR 249.12 7 CFR 249.9 7 CFR 249.18(b) 7 CFR 249.23(a), (b) 7 CFR 249.16(a) 7 CFR 249.6(a)(3)

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

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,092

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 6 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,605,037	-201,121	1,806,158
Annual IC Time Burden (Hours)	413,630	-51,275	464,905
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix 4 FNS-683a SFMNP Annual Financial and Program Data Report FPRS Screenshots	Appendix 4 FNS-683a FPRS Screenshots and PBStatement.pdf	05/24/2016

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