State Agency Requirement - Reporting, Third Party & Recordkeeping

Federal Collection Methods for Supplemental Nutrition Assistance Program Recipient Claims

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0446 can be found here:

Documents and Forms

Document Name Document Type
Appendix B - FNS-209 Screenshots from FPRS.docx Appendix B - FNS-209 Screenshots from FPRS IC Document
0584-0594 FPRS PBStatement _ExpDatDisplayed 9-30-2019.pdf FPRS Burden Statement for all FNS Worksheet IC Document

Information Collection (IC) Details

IC Title:	State Agency Requirement - Reporting, Third Party & Recordkeeping	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 7 CFR 272.1(f) 7 CFR 273.18(n)(1)(ii) 7 CFR 273.18(n)(1) 7 CFR 273.18(n)(4) 7 CFR 273.18(n)(2)

Information Collection 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: Claims Against Food Stamp Recipients	FR Citation: 69 FR 16513

Number of Respondents: 53	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 99 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	334,744	70,418	264,326
Annual IC Time Burden (Hours)	24,446	2,529	21,917
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Appendix B - FNS-209 Screenshots from FPRS	Appendix B - FNS-209 Screenshots from FPRS.docx	09/03/2019
FPRS Burden Statement for all FNS Worksheet	0584-0594 FPRS PBStatement _ExpDatDisplayed 9-30-2019.pdf	09/03/2019

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