Information Collection

State Agencies

IC 218873 under ICR 201812-0584-002 · OMB 0584-0605.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0605 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment 10 - 4032 Policy Memo Final July 2 2019.pdf Attachment 10 - 4032 Policy Memo Final	IC Document
Attachment 11 - 0584-0605 Annual State Report on Verificaion of SNAP Email Reminder w PBS 7-1-2019.pdf Attachment 11 - 0584-0605 Annual State Report on Verificaion of SNAP Email Remind	IC Document
Attachment 11A- Annual Email from FNS Reg Direct to State SNAP w-Implement Memo of Sec 4032 - AgriAct2014.pdf Attachment 11A- Annual Email from FNS Reg Direct to State SNAP w-Implement Memo of Sec 4032	IC Document

IC Title:

State Agencies

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 7 CFR 272.14 and 273.16

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

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 106

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	212	53	106	53
Annual IC Time Burden (Hours)	119	9	53	57
Annual IC Cost Burden (Dollars)	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment 10 - 4032 Policy Memo Final	Attachment 10 - 4032 Policy Memo Final July 2 2019.pdf	07/02/2019
Attachment 11 - 0584-0605 Annual State Report on Verificaion of SNAP Email Remind	Attachment 11 - 0584-0605 Annual State Report on Verificaion of SNAP Email Reminder w PBS 7-1-2019.pdf	07/02/2019
Attachment 11A- Annual Email from FNS Reg Direct to State SNAP w-Implement Memo of Sec 4032	Attachment 11A- Annual Email from FNS Reg Direct to State SNAP w-Implement Memo of Sec 4032 - AgriAct2014.pdf	07/02/2019

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