Information Collection

FNS User Access Request Form (State)

IC 184860 under ICR 202104-0584-005 · OMB 0584-0532.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0532 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FNS-674 FNS User Access Request Form (State)	Form
FNS-674 FNS User Access Request Form Appendix D FNS-674.pdf	Form
FNS-674 FNS User Access Request Form Appendix D FNS-674.pdf	Form
Appendix E User Guide for Completing the 674.pdf Appendix E User Guide for Completing the 674	IC Document
Appendix E User Guide for Completing the 674.pdf Appendix E User Guide for Completing the 674	IC Document

IC Title:

FNS User Access Request Form (State)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 5 CFR 732.101-103

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
Form	FNS-674	FNS User Access Request Form	Appendix D FNS-674.pdf		Yes	Yes	Fillable Fileable

Line of Business: Homeland Security

Subfunction: Key Asset and Critical Infrastructure Protection

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,520

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
	Approved	Previously Approved
Annual Number of Responses for this IC	5,040	5,040
Annual IC Time Burden (Hours)	840	840
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix E User Guide for Completing the 674	Appendix E User Guide for Completing the 674.pdf	04/27/2021

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