State, Local and Tribabl Government (CN Agency Staff, State Medicaid Agency Staff, Other State Agency Staff, School District) - Non-Response

Evaluation of the Direct Certification with Medicaid for Free and Reduced-Price (DCM-F/RP) Meals Demonstration

Documents and Forms

Document Name Document Type
NON RESPONDENTS BURDEN INSTRUMENT.doc Other-Non-Respondents Burden Instrum

Information Collection (IC) Details

IC Title:	State, Local and Tribabl Government (CN Agency Staff, State Medicaid Agency Staff, Other State Agency Staff, School District) - Non-Response	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Non-Respondents Burden Instrument			NON RESPONDENTS BURDEN INSTRUMENT.doc		No		Paper Only

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title: FNS-8 USDA/FNS Studies and Reports	FR Citation: 56 FR 19078

Number of Respondents: 4	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	14	3	11
Annual IC Time Burden (Hours)	1	0	1
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.