Information Collection

State, Local, or Tribal Government

IC 240788 under ICR 202112-0584-001 · OMB 0584-0652.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix C - EA Phase 3 Guidance April 2021 with State Template - FFCRA SNAP Emergency Allotment Request.pdf	Other-Appendix C - EA Phase 3 Guidan
Appendix C - EA Phase 3 Guidance April 2021 with State Template - FFCRA SNAP Emergency Allotment Request.pdf	Other-Appendix C - EA Phase 3 Guidan
FNS-292B Screensho SNAP Disaster Relief Appendix D - FNS292B Screenshot approved under Food Programs Reporting System (FPRS).jpg www.FPRS.gov	Form
FNS-292B Screensho SNAP Disaster Relief Appendix D - FNS292B Screenshot approved under Food Programs Reporting System (FPRS).jpg www.FPRS.gov	Form
Appendix D.1 - FPRS OMB Burden Statement and Expiration Date Screenshot.pdf Appendix D.1 - FPRS OMB Burden Statement and Expiration Date Screenshot.pdf	IC Document
Appendix D.1 - FPRS OMB Burden Statement and Expiration Date Screenshot.pdf Appendix D.1 - FPRS OMB Burden Statement and Expiration Date Screenshot.pdf	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

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
Other-Appendix C - EA Phase 3 Guidance April 2021 with State Template - FFCRA SNAP Emergency Allotment Request			Appendix C - EA Phase 3 Guidance April 2021 with State Template - FFCRA SNAP Emergency Allotment Request.pdf		Yes	No	Printable Only
Form	FNS-292B Screenshot	SNAP Disaster Relief	Appendix D - FNS292B Screenshot approved under Food Programs Reporting System (FPRS).jpg	www.FPRS.gov	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title: USDA/FNS-10: Persons Doing Business with the Food and Nutrition Service,

FR Citation: 65 FR 17251

Number of Respondents: 53

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	2,067	2,067
Annual IC Time Burden (Hours)	763	763
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix D.1 - FPRS OMB Burden Statement and Expiration Date Screenshot.pdf	Appendix D.1 - FPRS OMB Burden Statement and Expiration Date Screenshot.pdf	12/14/2021

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