Information Collection

Resource Sharing Form (State, Local & Tribal Government)

IC 182694 under ICR 201710-0584-004 · OMB 0584-0625.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

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.