Information Collection Request

Federal-State Supplemental Nutrition Programs Agreement (Form FNS-339)

ICR 202306-0584-004 · OMB 0584-0332 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form FNS-339 Federal State Supplemental Nutrition Program Agreement Form and Instruction Modified Available
Form FNS-339 WIC Federal and State Agreement FNS 339 Form and Instruction Modified Repair queued
FNS-339 Change Justification Memo-6292023-1.docx Justification for No Material/Nonsubstantive Change Uploaded 2023-06-30 Available
FNS-339 Change Justification Memo-6292023-1.docx Justification for No Material/Nonsubstantive Change Uploaded 2023-06-30 Repair queued
Supporting Statement 4.8.22.docx Supporting Statement A Uploaded 2022-04-12 Available
Supporting Statement 4.8.22.docx Supporting Statement A Uploaded 2022-04-12 Repair queued
Appendix C - FNS-339 Burden Table.xlsx Supplementary Document Uploaded 2022-04-07 Available
Appendix C - FNS-339 Burden Table.xlsx Supplementary Document Uploaded 2022-04-07 Repair queued
Appendix D - Invitation to Comment on Revised FNS-339 Form Burden Estimates.docx Supplementary Document Uploaded 2022-03-29 Available
Appendix D - Invitation to Comment on Revised FNS-339 Form Burden Estimates.docx Supplementary Document Uploaded 2022-03-29 Repair queued
Appendix B - Burden Narrative 2.17.22.docx Supplementary Document Uploaded 2022-03-29 Available
Appendix B - Burden Narrative 2.17.22.docx Supplementary Document Uploaded 2022-03-29 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
43553 WIC Federal and State Agreement FNS 339 Form and Instruction ModifiedFederal State Supplemental Nutrition Program Agreement
43553 WIC Federal and State Agreement FNS 339 Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
06/30/2025 06/30/2025 06/30/2025
254 0 254
32 0 32
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
WIC Federal and State Agreement FNS 339 FNS-339

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 254 254 0 0 0 0
Annual Time Burden (Hours) 32 32 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No