Information Collection

WIC ITO Program Staff ARPO ABFA Reporting - Tribal

IC 262007 under ICR 202308-0584-006 · OMB 0584-0687.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix E - Waiver Request Online Form.pdf	Other-
Appendix E - Waiver Request Online Form.pdf	Other-

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

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
Other-			Appendix E - Waiver Request Online Form.pdf		Yes	Yes	Fillable Printable

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 40

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	365	365
Annual IC Time Burden (Hours)	239	239
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.