Information Collection

State, Local or Tribal

IC 246113 under ICR 202103-0584-001 · OMB 0584-0671.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0671 can be found here:

2022-11-16 - No material or nonsubstantive change to a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix D1 Staff interview guide_6_24_21.docx	Other-Appendix D1 Staff interview gu
Appendix D2 Process mapping protocol_6-24-21.docx	Other-Appendix D2 Process mapping pr
Appendix G SNAP agency administrative data collection instrument.docx www.notyetcreated.com	Other-Appendix G SNAP agency adminis
Appendix H Child support agency administrative data collection instrument.docx www.notyetcreated.com	Other-Appendix H Child support agenc
Appendix I Cost data collection instrument.xlsx www.notyetcreated.com	Other-Appendix I Cost data collectio
Appendix N1 Template for email from FNS Regional Office to State SNAP agency_6_24_2021.docx Appendix N1 Template for email from FNS Regional Office to State SNAP agency	IC Document
Appendix N2 Template for email from FNS headquarters to State SNAP agency.docx Appendix N2 Template for email from FNS headquarters to State SNAP agency	IC Document
Appendix N3 Template for email from Office of Child Support Enforcement to State child support agency.docx Appendix N3 Template for email from Office of Child Support Enforcement to State child support agency	IC Document
Appendix N4 Template for email from study team to State child support and SNAP agencies.docx Appendix N4 Template for email from study team to State child support and SNAP agencies	IC Document
Appendix N5 Template for email from study team to local child support and SNAP agencies.docx Appendix N5 Template for email from study team to local child support and SNAP agencies	IC Document
Appendix N6 Project fact sheet.docx Appendix N6 Project fact sheet	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

State, Local or Tribal

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-Appendix D1 Staff interview guide	Appendix D1 Staff interview guide_6_24_21.docx		No		Paper Only
Other-Appendix D2 Process mapping protocol	Appendix D2 Process mapping protocol_6-24-21.docx		No		Paper Only
Other-Appendix G SNAP agency administrative data collection instrument	Appendix G SNAP agency administrative data collection instrument.docx	www.notyetcreated.com	Yes	Yes	Fillable Fileable
Other-Appendix H Child support agency administrative data collection instrument	Appendix H Child support agency administrative data collection instrument.docx	www.notyetcreated.com	Yes	Yes	Fillable Fileable
Other-Appendix I Cost data collection instrument	Appendix I Cost data collection instrument.xlsx	www.notyetcreated.com	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title: USDA/FNS 8 FNS Studies and Reports

FR Citation: 56 FR 19078

Number of Respondents: 352

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	780	780
Annual IC Time Burden (Hours)	1,017	1,017
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix N1 Template for email from FNS Regional Office to State SNAP agency	Appendix N1 Template for email from FNS Regional Office to State SNAP agency_6_24_2021.docx	07/26/2021
Appendix N2 Template for email from FNS headquarters to State SNAP agency	Appendix N2 Template for email from FNS headquarters to State SNAP agency.docx	05/25/2021
Appendix N3 Template for email from Office of Child Support Enforcement to State child support agency	Appendix N3 Template for email from Office of Child Support Enforcement to State child support agency.docx	05/25/2021
Appendix N4 Template for email from study team to State child support and SNAP agencies	Appendix N4 Template for email from study team to State child support and SNAP agencies.docx	05/25/2021
Appendix N5 Template for email from study team to local child support and SNAP agencies	Appendix N5 Template for email from study team to local child support and SNAP agencies.docx	05/25/2021
Appendix N6 Project fact sheet	Appendix N6 Project fact sheet.docx	05/25/2021

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