Information Collection

WIC Federal and State Agreement FNS 339

IC 43553 under ICR 201808-0584-003 · OMB 0584-0332.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0332 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FNS 339 WIC Federal and State Agreement FNS 339	Form and Instruction
FNS 339 Federal State Supplemental Nutrition Programs Agreement Attachment A - FNS-339.pdf www.fns.usda.gov/fns/forms.htm	Form and Instruction

IC Title:

WIC Federal and State Agreement FNS 339

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

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 339	Federal State Supplemental Nutrition Programs Agreement	Attachment A - FNS-339.pdf	http://www.fns.usda.gov/fns/forms.htm	Yes	No	Fillable Printable

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 129

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	258	134	124
Annual IC Time Burden (Hours)	32	1	31
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.