Private Sector- Business

Assessing SNAP Participants’ Fitness for Work (New)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0675 can be found here:

Documents and Forms

Document Name Document Type
Appendix E. Final SNAP E&T Provider Interview Guide.docx Other-Appendix E. Final SNAP E&T Pro
Appendix E. Final SNAP E&T Provider Interview Guide.docx Other-Appendix E. Final SNAP E&T Pro
Appendix G. Informed Consent Form.docx Other-Appendix G. Informed Consent F
Appendix G. Informed Consent Form.docx Other-Appendix G. Informed Consent F
Appendix F. Informed Consent Script for Interviews.docx Other-Appendix F. Informed Consent S
Appendix F. Informed Consent Script for Interviews.docx Other-Appendix F. Informed Consent S

Information Collection (IC) Details

IC Title:	Private Sector- Business	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-Appendix E. Final SNAP E&T Provider Interview Guide	Appendix E. Final SNAP E&T Provider Interview Guide.docx	No	Paper Only
Other-Appendix G. Informed Consent Form	Appendix G. Informed Consent Form.docx	No	Paper Only
Other-Appendix F. Informed Consent Script for Interviews	Appendix F. Informed Consent Script for Interviews.docx	No	Paper Only

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 80	Number of Respondents for Small Entity: 4

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	240	240
Annual IC Time Burden (Hours)	87	87
Annual IC Cost Burden (Dollars)	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.