Information Collection

State Agency (49); Local Agency (696)

IC 184656 under ICR 202105-0584-005 · OMB 0584-0447.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0447 can be found here:

2024-07-08 - Revision of a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix F- FY21 Consolidated State Plan Guidance Complete .pdf	Other-Appendix F Consolidated State
Appendix F- FY21 Consolidated State Plan Guidance Complete .pdf	Other-Appendix F Consolidated State
Appendix G- FY21 FMNP State Plan Guidance Complete.pdf	Other-Appendix G WIC FMNP State Plan
Appendix G- FY21 FMNP State Plan Guidance Complete.pdf	Other-Appendix G WIC FMNP State Plan
Appendix H- Upload Procedures for SFPD State Plans.docx	Other-Appendix H Upload Procedures f
Appendix H- Upload Procedures for SFPD State Plans.docx	Other-Appendix H Upload Procedures f
Appendix I Annual Financial and Program Data Report FNS-683B (1).jpg Appendix I Annual Financial and Program Data Report	IC Document
Appendix I Annual Financial and Program Data Report FNS-683B (1).jpg Appendix I Annual Financial and Program Data Report	IC Document
Appendix Ia Annual Financial and Program Data Report FNS-683B (1) Remarks section.pdf Appendix Ia Annual Financial and Program Data Report and Remarks	IC Document
Appendix Ia Annual Financial and Program Data Report FNS-683B (1) Remarks section.pdf Appendix Ia Annual Financial and Program Data Report and Remarks	IC Document
Appendix J- WIC Federal and State Agreements.pdf Appendix J WIC Federal and State Agreements	IC Document
Appendix J- WIC Federal and State Agreements.pdf Appendix J WIC Federal and State Agreements	IC Document
Appendix L FPRS Home Page with OMB Information.pdf Appendix L FPRS Home Page with OMB Disclosure Statement	IC Document
Appendix L FPRS Home Page with OMB Information.pdf Appendix L FPRS Home Page with OMB Disclosure Statement	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

State Agency (49); Local Agency (696)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 7 CFR 248.10(b)(5) 7 CFR 246.5 7 CFR 248.10(a)(4)(d) 7 CFR 248.10(b)(c) 7 CFR 248.4 7 CFR 248.6 7 CFR 248.10(i) 7 CFR 248.10(a)(4)(d) 7 CFR 248.10(b)(5) 7 CFR 248.10(d) 7 CFR 248.3(e) 7 CFR 248.10(e)(2), (3) 7 CFR 248.17(c)(1)(i) 7 CFR 248.10(e)(4) 7 CFR 248.10(f) 7 CFR 248.10(h) 7 CFR 248.10(j) 7 CFR 248.10(k) 7 CFR 248.11(a) 7 CFR 248.17(a) 7 CFR 248.17(b)(2)(ii) 7 CFR 248.17(c)(2) 7 CFR 248.18(b) 7 CFR 248.4(c) 7 CFR 248.9 7 CFR 248.16(a) 7 CFR 248.23(a) 7 CFR 248.11(c)

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Appendix F Consolidated State Plan Guidance	Appendix F- FY21 Consolidated State Plan Guidance Complete .pdf	Yes	No	Fillable Printable
Other-Appendix G WIC FMNP State Plan Guidance	Appendix G- FY21 FMNP State Plan Guidance Complete.pdf	Yes	No	Fillable Printable
Other-Appendix H Upload Procedures for SFPD State Plans	Appendix H- Upload Procedures for SFPD State Plans.docx	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:

FR Citation:

Number of Respondents: 744

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 48 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	3,139,280	6,905	-176,815	3,309,190
Annual IC Time Burden (Hours)	805,741	5,756	-45,848	845,833
Annual IC Cost Burden (Dollars)	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix I Annual Financial and Program Data Report	Appendix I Annual Financial and Program Data Report FNS-683B (1).jpg	05/27/2021
Appendix Ia Annual Financial and Program Data Report and Remarks	Appendix Ia Annual Financial and Program Data Report FNS-683B (1) Remarks section.pdf	05/27/2021
Appendix J WIC Federal and State Agreements	Appendix J- WIC Federal and State Agreements.pdf	05/27/2021
Appendix L FPRS Home Page with OMB Disclosure Statement	Appendix L FPRS Home Page with OMB Information.pdf	05/27/2021

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