Information Collection

Individuals/Households SNAP Participants Respondents

IC 238319 under ICR 201910-0584-005 · OMB 0584-0657.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
L. Participant Protocol.docx	Other-L. Participant Protocol
P. Client Consent Form for Observations.docx	Other-P. Client Consent Form for Obs
V. Description of Scheduling Tool.docx www.calendly.com/snapjobsearch	Other-V. Description of Scheduling T
W. Participant Call Script.docx	Other-W. Participant Call Script 3-1
U. Participant Advance Letter.docx U. Participant Advance Letter	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-L. Participant Protocol	L. Participant Protocol.docx		No		Paper Only
Other-P. Client Consent Form for Observations	P. Client Consent Form for Observations.docx		No		Paper Only
Other-V. Description of Scheduling Tool 3-12-2020	V. Description of Scheduling Tool.docx	www.calendly.com/snapjobsearch	Yes	Yes	Fillable Fileable Signable
Other-W. Participant Call Script 3-12-2020	W. Participant Call Script.docx		No		Paper Only

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title: USDA/FNS 10 Persons Doing Business with FNS

FR Citation: 65 FR 17251

Number of Respondents: 243

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	443	443
Annual IC Time Burden (Hours)	158	158
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
U. Participant Advance Letter	U. Participant Advance Letter.docx	02/06/2020

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