Information Collection

Worksheet FNS 648 OMB# 0431

IC 204753 under ICR 201904-0584-002 · OMB 0584-0594.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0594 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
FNS 648.pdf fprs.fns.usda.gov	Instruction
FNS 648 Guidance April 2014.pdf fprs.fns.usda.gov	Other-Working With WIC Clinics Guida
FNS 648 (screensho WIC Local Agency Directory FNS-648 Clinic.jpg fprs.fns.usda.gov	Form and Instruction
FNS 648 (screensho WIC Local Agency Directory FNS-648 Local Agency.jpg fprs.fns.usda.gov	Form and Instruction

IC Title:

Worksheet FNS 648 OMB# 0431

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 7 CFR 246.24

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
Instruction			FNS 648.pdf	https://fprs.fns.usda.gov	Yes	Yes	Fillable Fileable Signable
Other-Working With WIC Clinics Guidance for FNS 648			FNS 648 Guidance April 2014.pdf	https://fprs.fns.usda.gov	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FNS 648 (screenshot 2)	WIC Local Agency Directory	FNS-648 Local Agency.jpg	https://fprs.fns.usda.gov	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FNS 648 (screenshot 1)	WIC Local Agency Directory	FNS-648 Clinic.jpg	https://fprs.fns.usda.gov	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,826

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	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,826	-38	1,864
Annual IC Time Burden (Hours)	310	-7	317
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.