Appendix A_Burden Table - COVID AGency IC 11.4.20wcontractor

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Overview

Sample Burden Table - Studies
Sheet2
Sheet3

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Sheet 1: Sample Burden Table - Studies

Respondent Category	Type of respondents (optional)	Instruments	Number of respondents	Frequency of response	Total Annual responses	Hours per response	Annual burden (hours)	Hourly Wage Rate	Total Annualized Cost of Respondent Burden
State Government	SNAP State Agency	Waiver	53	24	1272	10	12,720.00	$17.53	$222,981.60
	SNAP State Agency	FFCRA Reporting	53	2	106	3	318.00	$17.53	$5,574.54
	SNAP State Agency	Weekly Oper.Update	53	52	2756	1	2,756.00	$17.53	$48,312.68
	SNAP State Agency	Continuing Resol Options	53	2	106	0.33	34.98	$17.53	$613.20
	WIC State Program Staff	Waiver	89	14	1246	0.25	311.50	$35.05	$10,918.08
	WIC State Program Staff	FFCRA Reporting	89	1	89	2	178.00	$35.05	$6,238.90
	WIC State Program Staff	MIS Data Pull Form	89	1	89	1.5	133.50	$35.05	$4,679.18
	FMNP State Program Staff	Waiver	49	3	147	0.25	36.75	$35.05	$1,288.09
	FMNP State Program Staff	FFCRA Reporting	49	1	49	3	147.00	$35.05	$5,152.35
	CN State Program Staff	Form: FNS10	56	24	1344	0.25	336.00	$35.05	$11,776.80
		Form: FNS44	57	12	684	0.25	171.00	$35.05	$5,993.55
		Form: FNS418	53	12	636	0.25	159.00	$35.05	$5,572.95
	Food Dist. State Program Staff	Form: FNS292A	60	52	3120	0.25	780.00	$35.05	$27,339.00
								$35.05
Local Government	WIC Local Agency Program Staff	FFCRA Reporting	1808	1	1808	1	1,808.00	$35.05	$63,370.40
Respondent	TOTAL		2,066	6.511	13,452	1.479	19,889.73		$419,811.31
								Fully loaded (total * 1.33)=	$558,349.04
Federal Cost	SNAP Administrative Cost Sharing								$277,482.02
	Federal Worker, GS13 Step 1	Waiver Request	1		2,665	0.25	666.25	$65.42	$43,587.87
	Federal Worker, GS13 Step 1	FFCRA Reporting	1		4716	3.0	14,148.00	$65.42	$925,600.36
	Federal Worker, GS13 Step 1	Review FNS292A	1		3120	0.25	780.00	$65.42	$51,029.71
	Total								$1,297,699.96
				Total responses	13,452
				electronic responses	6,198
				percent electronic	46.1%

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Sheet 2: Sheet2

		OMB #	Type of Request	How submitted	Assoc.Docs.
SNAP	Waiver Requests	0584-0083	This information is approved under the reference IC; We are asking for additional burden to cover the COVID-related waiver requests.	email	(instructions)
	Evaluation Data	0584-0654	This information was approved in the Emergency IC package referenced. This request extends this collection with additional burden hours to cover a longer time period.	email	(instructions)
	Weekly Operational Update	0584-0083	This information is approved under the referenced IC; States are required to submit this information in their State Plans and are required to update FNS of any changes. Because COVID is rapidly changing, FNS is seeking additional burden so states can report up to weekly, as needed, of any changes to their state plans due to COVID (i.e., SNAP applications; office closures; staff reductions). Note this is an estimate of the maximum burden FNS might needs for States; it could be less because the reporting is based on the level of changes, which varies based on the COVID data and need in a state at a given time.	email	??
	Continuing Res. Options	0584-0654	The CR adjusted how states can apply for a waiver. Instead of applying, they can simply inform FNS that they are using it within 5 days of adoption.	online form	(form)
WIC	Waiver Requests	0584-0654	This information was approved in the Emergency IC package referenced. This request extends this collection with additional burden hours to cover a longer time period.	online form	(form)
	Evaluation Data	0584-0654	This information was approved in the Emergency IC package referenced. This request extends this collection with additional burden hours to cover a longer time period. Note that in the Emergency IC FNS was trying to collect the data via State Plans but determined for reducing burden on states and improving FNS's ability to analyze the data, FNS has moved to a State and Local agency survey.	online form	(form)
	* State form				(form)
	* State MIS data pull				(instructions)
	* Local form				(form)
FMNP	Waiver Requests	0584-0654	This information was approved in the Emergency IC package referenced. This request extends this collection with additional burden hours to cover a longer time period.	?	(form)
	Evaluation Data	0584-0654	This information was approved in the Emergency IC package referenced. This request extends this collection with additional burden hours to cover a longer time period. Note that in the Emergency IC FNS was trying to collect the data via State Plans but determined for reducing burden on states and improving FNS's ability to analyze the data, FNS has moved to a State and Local agency survey.		(form)
CN	Waiver Requests	??	This activitiy is covered in the referenced IC and falls within existing burden approvals; FNS is not seeking anything related to CN waivers in this IC request.
	Evaluation Data	0584-0594	These three forms are covered under the referenced IC. FNS is seeking additional burden for the burden associated with adding the requested information to the remarks section of these three forms.	FNS FPRS reporting system
	* FNS-10			FPRS	form
	* FNS-44			FPRS	form
	* FNS-4xx			FPRS	form
FD	Commodities Use (FNS292A)	0584-0594	This form is covered under the referenced IC. FNS is seeking additional burden associated with changing from a one-time report to a weekly report during COVID.	email	form

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Sheet 3: Sheet3

Respondent Category	Type of respondents (optional)	Instruments	Number of respondents
State Government	SNAP State Agency	Waiver	53
	WIC State Program Staff	Waiver	89
	WIC State Program Staff	MIS Data Pull Form	89
	WIC State Program Staff	Instructions	89
	FMNP State Program Staff	Waiver	49
	FMNP State Program Staff	Evaluation Data	49
	CN State Program Staff	Form: FNS10	56
		Form: FNS44	57
		Form: FNS418	53
	Food Dist. State Program Staff	Form: FNS292A	60
Local Government	WIC Local Agency Program Staff	Evaluation Survey	1808
Respondent	TOTAL		2,066