Information Collection

State Agency Reporting & Recordkeeping FNS 380-1 - OMB 0584-0299 REVISED FOR AE79

IC 245270 under ICR 201909-0584-003 · OMB 0584-0692.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FNS 380-1 State Agency Reporting & Recordkeeping FNS 380-1 - OMB 0584-0299 REVISED FOR AE79	Form and Instruction
Form FNS 380-1 State Agency Reporting & Recordkeeping FNS 380-1 - OMB 0584-0299 REVISED FOR AE79	Form and Instruction
FNS 380-1 QUALITY CONTROL REVIEW SCHEDULE G- FNS 380-1 exp 9-30-26.pdf snapqcs.fns.usda.gov/	Form and Instruction

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(f)

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 380-1	QUALITY CONTROL REVIEW SCHEDULE	G- FNS 380-1 exp 9-30-26.pdf	https://snapqcs.fns.usda.gov/	Yes	Yes	Fillable Fileable Signable

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: 53

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	118,292	118,292
Annual IC Time Burden (Hours)	63,854	63,854
Annual IC Cost Burden (Dollars)	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.