Resource Sharing Form (State, Local & Tribal Government)

Food Stamp Nutrition Connection Resource Sharing Form

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0625 can be found here:

Documents and Forms

Document Name Document Type
Form FNS 889 Resource Sharing Form (State, Local & Tribal Government) Form and Instruction
FNS 889 SNAP Ed Connection Sharing Form Attachment 1 FNS 889.pdf snaped.fns.usda.gov Form and Instruction

Information Collection (IC) Details

IC Title:	Resource Sharing Form (State, Local & Tribal Government)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 7 CFR 272.2(2)(d)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FNS 889	SNAP Ed Connection Sharing Form	Attachment 1 FNS 889.pdf	https://snaped.fns.usda.gov	Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 10	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	50	-400	450
Annual IC Time Burden (Hours)	8	-70	78
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.