Information Collection

State Agency Requirement - Reporting, Third Party & Recordkeeping

IC 3061 under ICR 202205-0584-004 · OMB 0584-0446.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix B - FNS-209 Screenshots from FPRS.docx Appendix B- FNS-209 Screenshots from FPRS	IC Document
Appendix B - FNS-209 Screenshots from FPRS.docx Appendix B- FNS-209 Screenshots from FPRS	IC Document
Appendix E FPRS Homepage Screenshot for FNS 209.pdf FPRS PBS Statement for FNS Worksheet 209	IC Document
Appendix E FPRS Homepage Screenshot for FNS 209.pdf FPRS PBS Statement for FNS Worksheet 209	IC Document
Appendix G Certification Memo to States.pdf Appendix G Certification Memo to States.pdf	IC Document
Appendix G Certification Memo to States.pdf Appendix G Certification Memo to States.pdf	IC Document
Appendix H TOP Handbook.pdf Appendix H TOP Handbook.pdf	IC Document
Appendix H TOP Handbook.pdf Appendix H TOP Handbook.pdf	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 7 CFR 272.1(f) 7 CFR 273.18(n)(1)(ii) 7 CFR 273.18(n)(1) 7 CFR 273.18(n)(4) 7 CFR 273.18(n)(2)

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

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title: USDA/FNS 3 - Claims Against Food Stamp Recipients

FR Citation: 69 FR 16513

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	278,245	-56,499	334,744
Annual IC Time Burden (Hours)	22,397	-2,049	24,446
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix B- FNS-209 Screenshots from FPRS	Appendix B - FNS-209 Screenshots from FPRS.docx	08/01/2022
FPRS PBS Statement for FNS Worksheet 209	Appendix E FPRS Homepage Screenshot for FNS 209.pdf	08/01/2022
Appendix G Certification Memo to States.pdf	Appendix G Certification Memo to States.pdf	08/01/2022
Appendix H TOP Handbook.pdf	Appendix H TOP Handbook.pdf	08/01/2022

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