Information Collection

Private Sector- Business

IC 253893 under ICR 202205-0584-005 · OMB 0584-0675.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

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.