Information Collection

State Agencies

IC 244868 under ICR 202012-0584-002 · OMB 0584-0660.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0660 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment C_P-EBT Plan Template Schools.pdf	Other-Attachment C_P-EBT Plan Templa
Attachment C_P-EBT Plan Template Schools.pdf	Other-Attachment C_P-EBT Plan Templa
Appendix D_SNAP-D-292B.pdf Appendix D_SNAP-D-292B	IC Document
Appendix D_SNAP-D-292B.pdf Appendix D_SNAP-D-292B	IC Document
Attachment E_SNAP FNS-388.pdf Attachment E_SNAP FNS-388	IC Document
Attachment E_SNAP FNS-388.pdf Attachment E_SNAP FNS-388	IC Document
Attachment F_SNAP FNS-46.jpg Attachment F_SNAP FNS-46	IC Document
Attachment F_SNAP FNS-46.jpg Attachment F_SNAP FNS-46	IC Document
Attachment G_FNS-366A.pdf Attachment G_FNS-366A	IC Document
Attachment G_FNS-366A.pdf Attachment G_FNS-366A	IC Document
Attachment H_SF-425.pdf Attachment H_SF-425	IC Document
Attachment H_SF-425.pdf Attachment H_SF-425	IC Document

IC Title:

State Agencies

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	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Attachment C_P-EBT Plan Template Schools			Attachment C_P-EBT Plan Template Schools.pdf		Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title: USDA/FNS-10: Persons Doing Business with the Food and Nutrition Service

FR Citation: 65 FR 17251

Number of Respondents: 53

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,660,954	1,660,954
Annual IC Time Burden (Hours)	416,431	416,431
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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