Information Collection

State Agency Reviewers Reporting FNS 380 - OMB 0584-0074 Start-up Burden and ongoing recordkeeping REVISED FOR AE79

IC 238217 under ICR 201909-0584-003 · OMB 0584-0692.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FNS 380 State Agency Reviewers Reporting FNS 380 - OMB 0584-0074 Start-up Burden and ongoing recordkeeping REVISED FOR AE79	Form and Instruction
Form FNS 380 State Agency Reviewers Reporting FNS 380 - OMB 0584-0074 Start-up Burden and ongoing recordkeeping REVISED FOR AE79	Form and Instruction
FNS 380 WORKSHEET FOR QUALITY CONTROL REVIEWS F- FNS-380 with Instructions ex 7-31-2025.pdf snapqcs.fns.usda.gov/	Form and Instruction
D- October 2021 FNS Handbook 310- Revised_Feb 2022.pdf Appendix D FNS 310 Handbook	IC Document
H- SNAPQCS PIA.pdf Appendix H - SNAPQCS PIA for 0074	IC Document

IC Title:

Agency IC Tracking Number:

Rev for only the hours needed for the merge

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 7 CFR 275.12 7 CFR 275.12 (b) 7 CFR 275.12 and 275.21 (b)(1) 7 CFR 275.12 (d)(3) 7 CFR 275.12(d)(1) 7 CFR 275.12(e)

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 380	WORKSHEET FOR QUALITY CONTROL REVIEWS	F- FNS-380 with Instructions ex 7-31-2025.pdf	https://snapqcs.fns.usda.gov/	Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title: USDA.FNS-5 Information on Persons Disqualified from the Supplemental Nutrition Assistance Program

FR Citation: 75 FR 81205

Number of Respondents: 687

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
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	710,390	710,390
Annual IC Time Burden (Hours)	553,187	553,187
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix D FNS 310 Handbook	D- October 2021 FNS Handbook 310- Revised_Feb 2022.pdf	10/03/2023
Appendix H - SNAPQCS PIA for 0074	H- SNAPQCS PIA.pdf	10/03/2023

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