Information Collection

Supplemental Nutrition Assistance Program - Supplemental Nutrition Assistance for Victim of Disasters

IC 3036 under ICR 202207-0584-001 · OMB 0584-0336.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0336 can be found here:

2025-11-26 - Revision of a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix C_D-SNAP_Request_Template_0584-0336_9-29 Edits_Clean.docx	Other-Appendix C_D-SNAP_Request_Temp
Appendix C_D-SNAP_Request_Template_0584-0336_9-29 Edits_Clean.docx	Other-Appendix C_D-SNAP_Request_Temp
Appendix D.1_WIMS Public Burden Statement_0584-0336.jpg https:\\www.wims.fns.usda.gov	Other-Appendix D.1_WIMS Public Burde
Appendix D.1_WIMS Public Burden Statement_0584-0336.jpg https:\\www.wims.fns.usda.gov	Other-Appendix D.1_WIMS Public Burde
Appendix D_WIMS Request Screenshot_0584-0336.jpg https:\\www.wims.fns.usda.gov	Other-Appendix D_WIMS Request Screen
Appendix D_WIMS Request Screenshot_0584-0336.jpg https:\\www.wims.fns.usda.gov	Other-Appendix D_WIMS Request Screen
Appendix E_FNS-292A Screenshot_0584-0336.jpg Appendix E_FNS-292A Screenshot_0584-0336	IC Document
Appendix E_FNS-292A Screenshot_0584-0336.jpg Appendix E_FNS-292A Screenshot_0584-0336	IC Document
Appendix F_FNS-292-B Screenshot_0584-0336.pdf Appendix F_FNS-292-B Screenshot_0584-0336	IC Document
Appendix F_FNS-292-B Screenshot_0584-0336.pdf Appendix F_FNS-292-B Screenshot_0584-0336	IC Document
Appendix G_FNS-366A Screenshot_0584-0336.jpg Appendix G_FNS-366A Screenshot_0584-0336	IC Document
Appendix G_FNS-366A Screenshot_0584-0336.jpg Appendix G_FNS-366A Screenshot_0584-0336	IC Document
Appendix H_FNS-366B Screenshot_0584-0336.jpg Appendix H_FNS-366B Screenshot_0584-0336	IC Document
Appendix H_FNS-366B Screenshot_0584-0336.jpg Appendix H_FNS-366B Screenshot_0584-0336	IC Document
Appendix I_FPRS Public Burden Statement_0584-0336.pdf Appendix I_FPRS Public Burden Statement_0584-0336	IC Document
Appendix I_FPRS Public Burden Statement_0584-0336.pdf Appendix I_FPRS Public Burden Statement_0584-0336	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Supplemental Nutrition Assistance Program - Supplemental Nutrition Assistance for Victim of Disasters

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 7 CFR 273.7, 273.8(e) 7 CFR 273.9(a) 7 CFR 280 7 CFR 273.10(e), 273.10(f) 7 CFR 273.1(a), 273.2(f),

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Appendix C_D-SNAP_Request_Template_0584-0336	Appendix C_D-SNAP_Request_Template_0584-0336_9-29 Edits_Clean.docx		No		Paper Only
Other-Appendix D.1_WIMS Public Burden Statement_0584-0336	Appendix D.1_WIMS Public Burden Statement_0584-0336.jpg	https:\\www.wims.fns.usda.gov	Yes	Yes	Fillable Fileable Signable
Other-Appendix D_WIMS Request Screenshot_0584-0336	Appendix D_WIMS Request Screenshot_0584-0336.jpg	https:\\www.wims.fns.usda.gov	Yes	Yes	Fillable Fileable Signable

Federal Enterprise Architecture Business Reference Module

Line of Business: Disaster Management

Subfunction: Emergency Response

Privacy Act System of Records

Title: USDA/FNS 10 Persons Doing Business with FNS

FR Citation: 65 FR 17251

Number of Respondents: 5

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	14	7	7
Annual IC Time Burden (Hours)	112	56	56
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix E_FNS-292A Screenshot_0584-0336	Appendix E_FNS-292A Screenshot_0584-0336.jpg	09/28/2022
Appendix F_FNS-292-B Screenshot_0584-0336	Appendix F_FNS-292-B Screenshot_0584-0336.pdf	09/28/2022
Appendix G_FNS-366A Screenshot_0584-0336	Appendix G_FNS-366A Screenshot_0584-0336.jpg	09/28/2022
Appendix H_FNS-366B Screenshot_0584-0336	Appendix H_FNS-366B Screenshot_0584-0336.jpg	09/28/2022
Appendix I_FPRS Public Burden Statement_0584-0336	Appendix I_FPRS Public Burden Statement_0584-0336.pdf	09/28/2022

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