OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

SNAP, WIC, FMNP, and CN COVID-19 Waivers, Evaluation, and Reporting Data - State Agencies and WIC Local Government (SLT)

IC 241637 under ICR 202201-0584-001 · OMB 0584-0654.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Appendix I- SNAP Waiver Request & Reporting Data Instructions.pdf Other-Appendix I- SNAP Waiver Reques
Appendix I- SNAP Waiver Request & Reporting Data Instructions.pdf Other-Appendix I- SNAP Waiver Reques
Appendix J SNAP Weekly Operational Update (003).xlsx Other-Appendix J SNAP Weekly Operati
Appendix J SNAP Weekly Operational Update (003).xlsx Other-Appendix J SNAP Weekly Operati
Appendix K WIC State Agency Waiver FFCRA Reporting Data Online Form - Screenshots 10 27.docx Other-Appendix K WIC State Agency Wa
Appendix K WIC State Agency Waiver FFCRA Reporting Data Online Form - Screenshots 10 27.docx Other-Appendix K WIC State Agency Wa
Appendix L WIC MIS Data Pull Instructions 10.27.docx Other-Appendix L WIC MIS Data Pull I
Appendix L WIC MIS Data Pull Instructions 10.27.docx Other-Appendix L WIC MIS Data Pull I
Appendix M WIC MIS Data Pull Form.xlsx Other-Appendix M WIC MIS Data Pull F
Appendix M WIC MIS Data Pull Form.xlsx Other-Appendix M WIC MIS Data Pull F
Appendix N. FMNP State Agency Wiaver FFCRA Reporting Data Online form.docx Other-Appendix N. FMNP State Agency
Appendix N. FMNP State Agency Wiaver FFCRA Reporting Data Online form.docx Other-Appendix N. FMNP State Agency
Appendix O - Child Nutrition Program Waiver Request Guidance and reporting template.pdf Other-Appendix O - Child Nutrition P
Appendix O - Child Nutrition Program Waiver Request Guidance and reporting template.pdf Other-Appendix O - Child Nutrition P
Appendix Q WIC Local Agency Waiver FFCRA Reporting Data Online Form - Screenshots 10.27.docx Other-Appendix Q WIC Local Agency Wa
Appendix Q WIC Local Agency Waiver FFCRA Reporting Data Online Form - Screenshots 10.27.docx Other-Appendix Q WIC Local Agency Wa
Attachment to Appendix I of ICR EXAMPLE of Telephonic Signature Terms Conditions.pdf Other-Attachment to Appendix I of IC
Attachment to Appendix I of ICR EXAMPLE of Telephonic Signature Terms Conditions.pdf Other-Attachment to Appendix I of IC
Appendix P Commodities reporting data FNS 292A.xlsx
Appendix P Commodities reporting data FNS 292A		IC Document
Appendix P Commodities reporting data FNS 292A.xlsx
Appendix P Commodities reporting data FNS 292A		IC Document

Information Collection (IC) Details

View Information Collection (IC)

layout table

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 I- SNAP Waiver Request & Reporting Data Instructions Appendix I- SNAP Waiver Request & Reporting Data Instructions.pdf Yes No Printable Only
Other-Appendix J SNAP Weekly Operational Update (003) Appendix J SNAP Weekly Operational Update (003).xlsx Yes Yes Fillable Fileable
Other-Appendix K WIC State Agency Waiver FFCRA Reporting Data Online Form - Screenshots 10 27 Appendix K WIC State Agency Waiver FFCRA Reporting Data Online Form - Screenshots 10 27.docx Yes Yes Fillable Fileable Signable
Other-Appendix L WIC MIS Data Pull Instructions 10.27 Appendix L WIC MIS Data Pull Instructions 10.27.docx Yes No Printable Only
Other-Appendix M WIC MIS Data Pull Form Appendix M WIC MIS Data Pull Form.xlsx Yes Yes Fillable Fileable
Other-Appendix N. FMNP State Agency Wiaver FFCRA Reporting Data Online form Appendix N. FMNP State Agency Wiaver FFCRA Reporting Data Online form.docx Yes Yes Fillable Fileable
Other-Appendix O - Child Nutrition Program Waiver Request Guidance and reporting template Appendix O - Child Nutrition Program Waiver Request Guidance and reporting template.pdf Yes Yes Fillable Fileable
Other-Appendix Q WIC Local Agency Waiver FFCRA Reporting Data Online Form - Screenshots 10.27 Appendix Q WIC Local Agency Waiver FFCRA Reporting Data Online Form - Screenshots 10.27.docx Yes Yes Fillable Fileable
Other-Attachment to Appendix I of ICR EXAMPLE of Telephonic Signature Terms Conditions Attachment to Appendix I of ICR EXAMPLE of Telephonic Signature Terms Conditions.pdf Yes No Printable Only

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 193,034 0 179,582 0 0 13,452
Annual IC Time Burden (Hours) 113,136 0 93,246 0 0 19,890
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
Appendix P Commodities reporting data FNS 292A Appendix P Commodities reporting data FNS 292A.xlsx 01/21/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.