Information Collection

State Agency

IC 252688 under ICR 202204-0584-002 · OMB 0584-0672.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0672 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
0584-NEW-AppendixB-RFVPacket (2).pdf	Other-Request for Volunteers
0584-NEW-AppendixB-RFVPacket (2).pdf	Other-Request for Volunteers

IC Title:

State Agency

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

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-Request for Volunteers			0584-NEW-AppendixB-RFVPacket (2).pdf		No		Printable Only

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

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: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	25,346	25,346
Annual IC Time Burden (Hours)	28,975	28,975
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.