Information Collection

Household - 7 CFR 245

IC 45641 under ICR 202003-0584-002 · OMB 0584-0026.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0026 can be found here:

2023-07-31 - Revision of a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment J1. Prototype Household Application for Free and Reduced Price School Meals English.pdf	Other-Attachment J1 - Prototype Hous
Attachment J2. Prototype Household Application for Free and Reduced Price School Meals Albanian.pdf	Other-Attachment J2 - Prototype Hous
Attachment J3. Prototype Household Application for Free and Reduced Price School Meals Amharic.pdf	Other-Attachment J3 - Prototype Hous
Attachment J4. Prototype Household Application for Free and Reduced Price School Meals Arabic.pdf	Other-Attachment J4 - Prototype Hous
Attachment J5. Prototype Household Application for Free and Reduced Price School Meals Armenian.pdf	Other-Attachment J5 - Prototype Hous
Attachment J6. Prototype Household Application for Free and Reeduced Price Meals Bengali .pdf	Other-Attachment J6 - Prototype Hous
Attachment J7. Prototype Household Application for Free and Reeduced Price Meals Bosnian.pdf	Other-Attachment J7 - Prototype Hous
Attachment J8. Prototype Household Application for Free and Reduced Price School Meals Burmese.pdf	Other-Attachment J8 - Prototype Hous
AT5B22~1.PDF	Other-Attachment J9 - Prototype Hous
Attachment J10. Prototype Household Application for Chinese Trad.pdf	Other-Attachment J10 - Prototype Hou
Attachment J11. Prototype Household Application for Free and Reduced Price School Meals Croatian.pdf	Other-Attachment J11 - Prototype Hou
Attachment J12. Prototype Household Application Free and Reduced Price School Meals.pdf	Other-Attachment J12 - Prototype Hou
Attachment J13. Prototype Household Application for Free and Reduced Price School Meals French.pdf	Other-Attachment J13 - Prototype Hou
ATD33F~1.PDF	Other-Attachment J14 - Prototype Hou
Attachment J15. Prototype Household Application for Free and Reduced Price School Meals Greek.pdf	Other-Attachment J15 - Prototype Hou
Attachment J16. Prototype Household Application for Free and Reduced Price School Meals Gujarati.pdf	Other-Attachment J16 - Prototype Hou
ATDB46~1.PDF	Other-Attachment J17 - Prototype Hou
Attachment J18. Prototype Household Application for Free and Reduced Price School Meals Hindi.pdf	Other-Attachment J18 - Prototype Hou
Attachment J19. Prototype Household Application for Free and Reduced Price School Meals Hmong.pdf	Other-Attachment J19 - Prototype Hou
Attachment J20. Prototype Household Application for Free and Reduced Price School Meals Igbo.pdf	Other-Attachment J20 - Prototype Hou
Attachment J21. Prototype Household Application for Free and Reduced Price School Meals Ilokano.pdf	Other-Attachment J21 - Prototype Hou
Attachment J22. Prototype Household Application for Free and Reduced Price School Meals Italian.pdf	Other-Attachment J22 - Prototype Hou
Attachment J23. Prototype Household Application for Free and Reduced Price School Meals Iu Mien.pdf	Other-Attachment J23 - Prototype Hou
Attachment J24. Prototype Household Application Free Reduced Price SMeals Jamaican Creole PC.pdf	Other-Attachment J24 - Prototype Hou
Attachment J25. Prototype Household Application for Free and Reduced Price School Meals Japanese.pdf	Other-Attachment J25 - Prototype Hou
Attachment J26. Prototype Household Application for Free and Reduced Price School Meals Karen.pdf	Other-Attachment J26 - Prototype Hou
Attachment J27. Prototype Household Application for Free and Reduced Price School Meals Khmer.pdf	Other-Attachment J27 - Prototype Hou
Attachment J28. Prototype Household Application for Free and Reduced Price School Meals Korean.pdf	Other-Attachment J28 - Prototype Hou
Attachment J29. Prototype Household Application for Free and Reduced Price School Meals Kru.pdf	Other-Attachment J29 - Prototype Hou
Attachment J30. Prototype Household Application for Free and Reduced Price School Meals Kurdish.pdf	Other-Attachment J30 - Prototype Hou
Attachment J31. Prototype Household Application for Free and Reduced Price School Meals Laotian.pdf	Other-Attachment J31 - Prototype Hou
Attachment J32. Prototype Household Application for Free and Reduced Price School Meals Nepali.pdf	Other-Attachment J32 - Prototype Hou
Attachment J33. Prototype Household Application for Free and Reduced Price School Meals Polish.pdf	Other-Attachment J33 - Prototype Hou
AT7302~1.PDF	Other-Attachment J34 - Prototype Hou
Attachment J35. Prototype Household Application for Free and Reduced Price School Meals Punjabi.pdf	Other-Attachment J35 - Prototype Hou
Attachment J36. Prototype Household Application for Free and Reduced Price School Meals Romanian.pdf	Other-Attachment J36 - Prototype Hou
Attachment J37. Prototype Household Application for Free and Reduced Price School Meals Russian.pdf	Other-Attachment J37 - Prototype Hou
Attachment J38. Prototype Household Application for Free and Reduced Price School Meals Samoan.pdf	Other-Attachment J38 - Prototype Hou
Attachment J39. Prototype Household Application for Free and Reduced Price School Meals Serbian.pdf	Other-Attachment J39 - Prototype Hou
Attachment J40. Prototype Household Application for Free and Reduced Price School Meals Somali.pdf	Other-Attachment J40 - Prototype Hou
Attachment J41. Prototype Household Application for Free and Reduced Price School Meals Spanish.pdf	Other-Attachment J41 - Prototype Hou
Attachment J42. Prototype Household Application for Free and Reduced Price School Meals Sudanese.pdf	Other-Attachment J42 - Prototype Hou
Attachment J43. Prototype Household Application for Free and Reduced Price School Meals Tagalog.pdf	Other-Attachment J43 - Prototype Hou
Attachment J44. Prototype Household Application for Free and Reduced Price School Meals Thai.pdf	Other-Attachment J44 - Prototype Hou
Attachment J45. Prototype Household Application for Free and Reduced Price School Meals Tigrinya.pdf	Other-Attachment J45 - Prototype Hou
Attachment J46. Prototype Household Application for Free and Reduced Price School Meals Ukranian.pdf	Other-Attachment J46 - Prototype Hou
Attachment J47. Prototype Household Application for Free and Reduced Price School Meals Urdu.pdf	Other-Attachment J47 - Prototype Hou
Attachment J48. Prototype Household Application for Free and Reduced Price School Meals Vietnamese.pdf	Other-Attachment J48 - Prototype Hou
Attachment J49. Prototype Household Application for Free and Reduced Price School Meals Yiddish.pdf	Other-Attachment J49 - Prototype Hou
Attachment J50. Prototype Household Application for Free and Reduced Price School Meals Yoruba.pdf	Other-Attachment J50 - Prototype Hou
Attachment K. Prototype Application Instructions.pdf	Other-Attachment K - Prototype Appli
Attachment L. Prototype Letter to Households.pdf Attachment L - Prototype Letter to Households	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Household - 7 CFR 245

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 7 CFR 245.6(a) & 245.6a(a)(7)(i) 7 CFR 245.6(a)(1) 7 CFR 245.6a(a)(7)(ii) 7 CFR 215.13a(g)(2)(iv)

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-Attachment J38 - Prototype Household Application for Free and Reduced Price School Meals (Samoan)	Attachment J38. Prototype Household Application for Free and Reduced Price School Meals Samoan.pdf	No	Paper Only
Other-Attachment J39 - Prototype Household Application for Free and Reduced Price School Meals (Serbian)	Attachment J39. Prototype Household Application for Free and Reduced Price School Meals Serbian.pdf	No	Paper Only
Other-Attachment J40 - Prototype Household Application for Free and Reduced Price School Meals (Somali)	Attachment J40. Prototype Household Application for Free and Reduced Price School Meals Somali.pdf	No	Paper Only
Other-Attachment J41 - Prototype Household Application for Free and Reduced Price School Meals (Spanish)	Attachment J41. Prototype Household Application for Free and Reduced Price School Meals Spanish.pdf	No	Paper Only
Other-Attachment J42 - Prototype Household Application for Free and Reduced Price School Meals (Sudanese)	Attachment J42. Prototype Household Application for Free and Reduced Price School Meals Sudanese.pdf	No	Paper Only
Other-Attachment J43 - Prototype Household Application for Free and Reduced Price School Meals (Tagalog)	Attachment J43. Prototype Household Application for Free and Reduced Price School Meals Tagalog.pdf	No	Paper Only
Other-Attachment J44 - Prototype Household Application for Free and Reduced Price School Meals (Thai)	Attachment J44. Prototype Household Application for Free and Reduced Price School Meals Thai.pdf	No	Paper Only
Other-Attachment J45 - Prototype Household Application for Free and Reduced Price School Meals (Tigrinya)	Attachment J45. Prototype Household Application for Free and Reduced Price School Meals Tigrinya.pdf	No	Paper Only
Other-Attachment J46 - Prototype Household Application for Free and Reduced Price School Meals (Ukrainian)	Attachment J46. Prototype Household Application for Free and Reduced Price School Meals Ukranian.pdf	No	Paper Only
Other-Attachment J47 - Prototype Household Application for Free and Reduced Price School Meals (Urdu)	Attachment J47. Prototype Household Application for Free and Reduced Price School Meals Urdu.pdf	No	Paper Only
Other-Attachment J48 - Prototype Household Application for Free and Reduced Price School Meals (Vietnamese)	Attachment J48. Prototype Household Application for Free and Reduced Price School Meals Vietnamese.pdf	No	Paper Only
Other-Attachment J49 - Prototype Household Application for Free and Reduced Price School Meals (Yiddish)	Attachment J49. Prototype Household Application for Free and Reduced Price School Meals Yiddish.pdf	No	Paper Only
Other-Attachment J50 - Prototype Household Application for Free and Reduced Price School Meals (Yoruba)	Attachment J50. Prototype Household Application for Free and Reduced Price School Meals Yoruba.pdf	No	Paper Only
Other-Attachment K - Prototype Application Instructions	Attachment K. Prototype Application Instructions.pdf	No	Paper Only
Other-Attachment J18 - Prototype Household Application for Free and Reduced Price School Meals (Hindi)	Attachment J18. Prototype Household Application for Free and Reduced Price School Meals Hindi.pdf	No	Paper Only
Other-Attachment J19 - Prototype Household Application for Free and Reduced Price School Meals (Hmong)	Attachment J19. Prototype Household Application for Free and Reduced Price School Meals Hmong.pdf	No	Paper Only
Other-Attachment J20 - Prototype Household Application for Free and Reduced Price School Meals (Igbo)	Attachment J20. Prototype Household Application for Free and Reduced Price School Meals Igbo.pdf	No	Paper Only
Other-Attachment J21 - Prototype Household Application for Free and Reduced Price School Meals (Ilkano)	Attachment J21. Prototype Household Application for Free and Reduced Price School Meals Ilokano.pdf	No	Paper Only
Other-Attachment J14 - Prototype Household Application for Free and Reduced Price School Meals (French Creole)	ATD33F~1.PDF	No	Paper Only
Other-Attachment J15 - Prototype Household Application for Free and Reduced Price School Meals (Greek)	Attachment J15. Prototype Household Application for Free and Reduced Price School Meals Greek.pdf	No	Paper Only
Other-Attachment J16 - Prototype Household Application for Free and Reduced Price School Meals (Gujarati)	Attachment J16. Prototype Household Application for Free and Reduced Price School Meals Gujarati.pdf	No	Paper Only
Other-Attachment J17 - Prototype Household Application for Free and Reduced Price School Meals (Haitian Creole)	ATDB46~1.PDF	No	Paper Only
Other-Attachment J22 - Prototype Household Application for Free and Reduced Price School Meals (Italian)	Attachment J22. Prototype Household Application for Free and Reduced Price School Meals Italian.pdf	No	Paper Only
Other-Attachment J23 - Prototype Household Application for Free and Reduced Price School Meals (lu Mien)	Attachment J23. Prototype Household Application for Free and Reduced Price School Meals Iu Mien.pdf	No	Paper Only
Other-Attachment J24 - Prototype Household Application for Free and Reduced Price School Meals (Jamaican Creole)	Attachment J24. Prototype Household Application Free Reduced Price SMeals Jamaican Creole PC.pdf	No	Paper Only
Other-Attachment J25 - Prototype Household Application for Free and Reduced Price School Meals (Japanese)	Attachment J25. Prototype Household Application for Free and Reduced Price School Meals Japanese.pdf	No	Paper Only
Other-Attachment J26 - Prototype Household Application for Free and Reduced Price School Meals (Karen)	Attachment J26. Prototype Household Application for Free and Reduced Price School Meals Karen.pdf	No	Paper Only
Other-Attachment J27 - Prototype Household Application for Free and Reduced Price School Meals (Khmer)	Attachment J27. Prototype Household Application for Free and Reduced Price School Meals Khmer.pdf	No	Paper Only
Other-Attachment J28 - Prototype Household Application for Free and Reduced Price School Meals (Korean)	Attachment J28. Prototype Household Application for Free and Reduced Price School Meals Korean.pdf	No	Paper Only
Other-Attachment J29 - Prototype Household Application for Free and Reduce Price School Meals (Kru)	Attachment J29. Prototype Household Application for Free and Reduced Price School Meals Kru.pdf	No	Paper Only
Other-Attachment J30 - Prototype Household Application for Free and Reduced Price School Meals (Kurdish)	Attachment J30. Prototype Household Application for Free and Reduced Price School Meals Kurdish.pdf	No	Paper Only
Other-Attachment J31 - Prototype Household Application for Free and Reduced Price School Meals (Laotian)	Attachment J31. Prototype Household Application for Free and Reduced Price School Meals Laotian.pdf	No	Paper Only
Other-Attachment J32 - Prototype Household Application for Free and Reduced Price School Meals (Nepali)	Attachment J32. Prototype Household Application for Free and Reduced Price School Meals Nepali.pdf	No	Paper Only
Other-Attachment J33 - Prototype Household Application for Free and Reduced Price School Meals (Polish)	Attachment J33. Prototype Household Application for Free and Reduced Price School Meals Polish.pdf	No	Paper Only
Other-Attachment J34 - Prototype Household Application for Free and Reduced Price School Meals (Portuguese)	AT7302~1.PDF	No	Paper Only
Other-Attachment J35 - Prototype Household Application for Free and Reduced Price School Meals (Punjabi)	Attachment J35. Prototype Household Application for Free and Reduced Price School Meals Punjabi.pdf	No	Paper Only
Other-Attachment J36 - Prototype Household Application for Free and Reduced Price School Meals (Romanian)	Attachment J36. Prototype Household Application for Free and Reduced Price School Meals Romanian.pdf	No	Paper Only
Other-Attachment J37 - Prototype Household Application for Free and Reduced Price School Meals (Russian)	Attachment J37. Prototype Household Application for Free and Reduced Price School Meals Russian.pdf	No	Paper Only
Other-Attachment J4 - Prototype Household Application for Free and Reduced Price School Meals (Arabic)	Attachment J4. Prototype Household Application for Free and Reduced Price School Meals Arabic.pdf	No	Paper Only
Other-Attachment J5 - Prototype Household Application for Free and Reduced Price School Meals (Armenian)	Attachment J5. Prototype Household Application for Free and Reduced Price School Meals Armenian.pdf	No	Paper Only
Other-Attachment J6 - Prototype Household Application for Free and Reduced Price School Meals (Bengali)	Attachment J6. Prototype Household Application for Free and Reeduced Price Meals Bengali .pdf	No	Paper Only
Other-Attachment J7 - Prototype Household Application for Free and Reduced Price School Meals (Bosnian)	Attachment J7. Prototype Household Application for Free and Reeduced Price Meals Bosnian.pdf	No	Paper Only
Other-Attachment J8 - Prototype Household Application for Free and Reduced Price School Meals (Burmese)	Attachment J8. Prototype Household Application for Free and Reduced Price School Meals Burmese.pdf	No	Paper Only
Other-Attachment J9 - Prototype Household Application for Free and Reduced Price School Meals (Chinese Simplified)	AT5B22~1.PDF	No	Paper Only
Other-Attachment J10 - Prototype Household Application for Free and Reduced Price School Meals (Chinese Traditional)	Attachment J10. Prototype Household Application for Chinese Trad.pdf	No	Paper Only
Other-Attachment J11 - Prototype Household Application for Free and Reduced Price School Meals (Croatian)	Attachment J11. Prototype Household Application for Free and Reduced Price School Meals Croatian.pdf	No	Paper Only
Other-Attachment J1 - Prototype Household Application for Free and Reduced Price School Meals (English)	Attachment J1. Prototype Household Application for Free and Reduced Price School Meals English.pdf	No	Paper Only
Other-Attachment J2 - Prototype Household Application for Free and Reduced Price School Meals (Albanian)	Attachment J2. Prototype Household Application for Free and Reduced Price School Meals Albanian.pdf	No	Paper Only
Other-Attachment J3 - Prototype Household Application for Free and Reduced Price School Meals (Amharic)	Attachment J3. Prototype Household Application for Free and Reduced Price School Meals Amharic.pdf	No	Paper Only
Other-Attachment J12 - Prototype Household Application for Free and Reduced Price School Meals (Farsi)	Attachment J12. Prototype Household Application Free and Reduced Price School Meals.pdf	No	Paper Only
Other-Attachment J13 - Prototype Household Application for Free and Reduced Price School Meals (French)	Attachment J13. Prototype Household Application for Free and Reduced Price School Meals French.pdf	No	Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,551,886

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	3,653,373	3,922	-1,886,049	5,535,500
Annual IC Time Burden (Hours)	441,049	476	-230,527	671,100
Annual IC Cost Burden (Dollars)	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment L - Prototype Letter to Households	Attachment L. Prototype Letter to Households.pdf	03/30/2020

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