SNAP Forms: Applications, Periodic Reporting, Notices

Forms and Documents

Document Name	Status
Appendix A_OMB 0584-0064 Burden Narrative 112916.docx Supplementary Document	2016-12-01
Appendix B_OMB 0584-0064 Burden Table 112916.xlsx Supplementary Document	2016-12-01
OMB 0584-0064 EC ET Final Rule_Supporting Statement (Final 071217).docx Supporting Statement A	2017-07-12

IC Document Collections

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

ICR Details

OMB Control No: 0584-0064	ICR Reference No: 201611-0584-003
Status: Active	Previous ICR Reference No: 201511-0584-006
Agency/Subagency: USDA/FNS	Agency Tracking No: AD87
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 with change	Conclusion Date: 07/13/2017
	Date Received in OIRA: 01/09/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2020	36 Months From Approved	05/31/2019
Responses	643,938,886	0	658,539,828
Time Burden (Hours)	77,690,005	0	118,221,440
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): US Code: 7 USC 2011, et. seq. Name of Law: Food and Nutrition Act of 2008
   PL: Pub.L. 110 - 246 Subtitle A Name of Law: Food, Conservation and Energy Act of 2008
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0584-AD87	Final or interim final rulemaking	82 FR 2010	01/06/2017

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 25413	05/11/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 2010	01/06/2017
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	643,938,886	658,539,828	0	-14,600,942	0	0
Annual Time Burden (Hours)	77,690,005	118,221,440	0	-40,531,435	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: Changing Regulations

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

Burden Reduction Due to: Changing Regulations

Short Statement: There is a net decrease to OMB Control Number 0584-0064 of 40,531,435 hours due to program changes associated with rulemaking. There was an increase of 522,659 hours for States primarily due to the expansion of simplified reporting to include newly added elderly or disabled households, and a 41,054,094 hours decrease to SNAP recipients primarily due to changes to SNAP application interviews.

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Annual Cost to Federal Government: $367,149,310

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: 01/09/2017

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