Information Collection

SNAP Agency Matching Program Performance Reporting Tool and Instructions

IC 217786 under ICR 202111-0970-005 · OMB 0970-0464.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0464 can be found here:

Documents and Forms

Document Name Document Type
Form 1 SNAP Agency Matching Program Performance Reporting Tool and Instructions Form
0970-0464_State_SNAP_Agency_NDNH_Matching_Program_Performance_Reporting_Instructions.docx Instruction
0970-0464_State_SNAP_Agency_NDNH_Matching_Program_Performance_Reporting_Instructions.docx Instruction
1 SNAP-Agency NDNH Match Results Performance Reporting Too 0970-0464_State SNAP_Agency_NDNH_Matching_Program_Performance_Reporting_Tool.xls Form
1 SNAP-Agency NDNH Match Results Performance Reporting Too 0970-0464_State SNAP_Agency_NDNH_Matching_Program_Performance_Reporting_Tool.xls Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	SNAP Agency Matching Program Performance Reporting Tool and Instructions	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	SNAP-Agency NDNH Match Results Performance Reporting Tool	0970-0464_State SNAP_Agency_NDNH_Matching_Program_Performance_Reporting_Tool.xls		Yes	Yes	Fillable Printable
Instruction			0970-0464_State_SNAP_Agency_NDNH_Matching_Program_Performance_Reporting_Instructions.docx		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 53	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	53	0	53
Annual IC Time Burden (Hours)	44	-58	102
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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