Information Collection

States- SNAP Repayment Demand and Program Disqualification

IC 3099 under ICR 201706-0584-002 · OMB 0584-0492.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0492 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
eDRS front page.docx www.fns.usda.gov	Other-eDRS Screen Shot
AdminGuide.pdf www.fns.usda.gov	Instruction
AdminQuickGuide.pdf www.fns.usda.gov	Instruction
eDRS Screen Shots.docx www.fns.usda.gov	Other-eDRS Screen Shots
UserGuide.pdf www.fns.usda.gov	Instruction
UserQuickGuide.pdf www.fns.usda.gov	Instruction
Appendix 2 eDRS Home Page updated 3-22-18.pdf www.fns.usda.gov	Other-eDRS Home Page with PBS

IC Title:

States- SNAP Repayment Demand and Program Disqualification

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 7 CFR 273.18 7 CFR 273.16(h) 7 CFR 273.16(e)(3) 7 CFR 273.16 7 CFR 273.18(e)(3)(iv)

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-eDRS Screen Shot	eDRS front page.docx	www.fns.usda.gov	Yes	Yes	Fillable Fileable Signable
Instruction	AdminGuide.pdf	www.fns.usda.gov	Yes	Yes	Fillable Fileable
Instruction	AdminQuickGuide.pdf	www.fns.usda.gov	Yes	Yes	Fillable Fileable Signable
Other-eDRS Screen Shots	eDRS Screen Shots.docx	www.fns.usda.gov	Yes	Yes	Fillable Fileable Signable
Instruction	UserGuide.pdf	www.fns.usda.gov	Yes	Yes	Fillable Fileable Signable
Instruction	UserQuickGuide.pdf	www.fns.usda.gov	Yes	Yes	Fillable Fileable Signable
Other-eDRS Home Page with PBS	Appendix 2 eDRS Home Page updated 3-22-18.pdf	www.fns.usda.gov	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title: Claims Against Food Stamp Recipients

FR Citation: 63 FR 14894

Number of Respondents: 53

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	2,054,931	959,913	1,095,018
Annual IC Time Burden (Hours)	171,752	-3,209	174,961
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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