SNAP Nutrition Connection Resource Sharing Form 889

Forms and Documents

Document Name	Status
Form FNS 889 Resource Sharing Form (State, Local & Tribal Government) Form and Instruction	Modified
Form FNS 889 Resource Sharing Form (Business - Private) Form and Instruction	Modified
Attachment 4 Legal Authority 7 CFR(d)(2) SNAP-Ed.docx Supplementary Document	2021-04-29
Attachment 3 Legal Authority.pdf Supplementary Document	2021-04-29
Attachment 2 Burden Estimate 4-26-21.xlsx Supplementary Document	2021-04-28
OMB 0584-0625 Supporting Statement 2021-UK 3 PRAO-OCIO comments 4-30-2021 round3_clean.docx Supporting Statement A	2021-04-30

IC Document Collections

IC ID	Document Title	Status
182694	Resource Sharing Form (State, Local & Tribal Government) Form and Instruction	Modified
1016	Resource Sharing Form (Business - Private) Form and Instruction	Modified

ICR Details

OMB Control No: 0584-0625	ICR Reference No: 202104-0584-002
Status: Received in OIRA	Previous ICR Reference No: 201710-0584-004
Agency/Subagency: USDA/FNS	Agency Tracking No:
Title: SNAP Nutrition Connection Resource Sharing Form 889
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 04/30/2021

	Requested	Previously Approved
Expiration Date	36 Months From Approved	04/30/2021
Responses	110	110
Time Burden (Hours)	18	18
Cost Burden (Dollars)	0	0

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Abstract: This voluntary "Sharing Form FNS 889" will help the Food and Nutrition Information Center (FNIC) identify existing nutrition education and training resources for review and inclusion in an online database.

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Authorizing Statute(s): PL: Pub.L. 113 - 128 28 Name of Law: The Food and Nutrition Act (FNA) of 2008
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 9477	02/16/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 22132	04/27/2021
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Resource Sharing Form (Business - Private)	FNS 889	SNAP Ed Connection Sharing Form
Resource Sharing Form (State, Local & Tribal Government)	FNS 889	SNAP Ed Connection Sharing Form

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ICR Summary of Burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	110	110	0	0	0	0
Annual Time Burden (Hours)	18	18	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $24,870

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 04/30/2021

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