Information Collection

State, Local, and Tribal Government Respondents

IC 263398 under ICR 202311-0584-001 · OMB 0584-0693.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix B. SNAP agency survey and document request.docx	Other-Appendix B. SNAP agency survey
Appendix C. SNAP agency case study interview discussion guide.docx	Other-Appendix C. SNAP agency case s
Appendix C. SNAP agency case study interview discussion guide.docx	Other-Appendix C. SNAP agency case s
Appendix D. Survey screenshots.docx	Other-Appendix D. Survey screenshots
Appendix D. Survey screenshots.docx	Other-Appendix D. Survey screenshots
Appendix J.1 Template for email from FNS to State SNAP agency about the survey.docx	Other-Appendix J.1 Template for emai
Appendix J.1 Template for email from FNS to State SNAP agency about the survey.docx	Other-Appendix J.1 Template for emai
Appendix J.2 Template for email from Mathematica to State SNAP agency about the survey.docx	Other-Appendix J.2 Template for emai
Appendix J.2 Template for email from Mathematica to State SNAP agency about the survey.docx	Other-Appendix J.2 Template for emai
Appendix J.3 Template for email from Mathematica to newly assigned respondents about the survey.docx	Other-Appendix J.3 Template for emai
Appendix J.3 Template for email from Mathematica to newly assigned respondents about the survey.docx	Other-Appendix J.3 Template for emai
Appendix K.1 Template for email from FNS to State SNAP agency about the case studies.docx	Other-Appendix K.1 Template for emai
Appendix K.1 Template for email from FNS to State SNAP agency about the case studies.docx	Other-Appendix K.1 Template for emai
Appendix K.2 Template for email from Mathematica to State SNAP agency about the case studies.docx	Other-Appendix K.2 Template for emai
Appendix K.2 Template for email from Mathematica to State SNAP agency about the case studies.docx	Other-Appendix K.2 Template for emai
Appendix K.4. Case study call script.docx	Other-Appendix K.4. Case study call
Appendix K.4. Case study call script.docx	Other-Appendix K.4. Case study call
Appendix B. SNAP agency survey and document request 2.5.2024.docx	Other-Appendix B. SNAP agency survey
Appendix J.4 Template for document reminder email for the survey.docx Appendix J.4 Template for document reminder email for the survey	IC Document
Appendix J.4 Template for document reminder email for the survey.docx Appendix J.4 Template for document reminder email for the survey	IC Document
Appendix J.5 Template for biweekly reminder email for SNAP administrators about the survey.docx Appendix J.5 Template for biweekly reminder email for SNAP administrators about the survey	IC Document
Appendix J.5 Template for biweekly reminder email for SNAP administrators about the survey.docx Appendix J.5 Template for biweekly reminder email for SNAP administrators about the survey	IC Document
Appendix J.6 Template for biweekly reminder email for respondents for the survey.docx Appendix J.6 Template for biweekly reminder email for respondents for the survey	IC Document
Appendix J.6 Template for biweekly reminder email for respondents for the survey.docx Appendix J.6 Template for biweekly reminder email for respondents for the survey	IC Document
Appendix J.7 Urgent reminder email for SNAP administrators about the survey.docx Appendix J.7 Urgent reminder email for SNAP administrators about the survey	IC Document
Appendix J.7 Urgent reminder email for SNAP administrators about the survey.docx Appendix J.7 Urgent reminder email for SNAP administrators about the survey	IC Document
Appendix J.8 Urgent reminder email for respondents about the survey.docx Appendix J.8 Urgent reminder email for respondents about the survey	IC Document
Appendix J.8 Urgent reminder email for respondents about the survey.docx Appendix J.8 Urgent reminder email for respondents about the survey	IC Document
Appendix J.9 Survey reminder call script.docx Appendix J.9 Survey reminder call script	IC Document
Appendix J.9 Survey reminder call script.docx Appendix J.9 Survey reminder call script	IC Document
Appendix K.3. Template for sched. reminder email from Mathematica to SNAP State agency for the case studies.docx Appendix K.3. Template for sched. reminder email from Mathematica to SNAP State agency for the case studies	IC Document
Appendix K.3. Template for sched. reminder email from Mathematica to SNAP State agency for the case studies.docx Appendix K.3. Template for sched. reminder email from Mathematica to SNAP State agency for the case studies	IC Document
Appendix M. Study description.docx Appendix M. Study description	IC Document
Appendix M. Study description.docx Appendix M. Study description	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

State, Local, and Tribal Government Respondents

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?	Can Be Submitted Electronically?	Electronic Capability
Other-Appendix C. SNAP agency case study interview discussion guide	Appendix C. SNAP agency case study interview discussion guide.docx	No		Paper Only
Other-Appendix D. Survey screenshots	Appendix D. Survey screenshots.docx	Yes	Yes	Fillable Fileable
Other-Appendix J.1 Template for email from FNS to State SNAP agency about the survey	Appendix J.1 Template for email from FNS to State SNAP agency about the survey.docx	Yes	Yes	Printable Only
Other-Appendix J.2 Template for email from Mathematica to State SNAP agency about the survey	Appendix J.2 Template for email from Mathematica to State SNAP agency about the survey.docx	Yes	Yes	Printable Only
Other-Appendix J.3 Template for email from Mathematica to newly assigned respondents about the survey	Appendix J.3 Template for email from Mathematica to newly assigned respondents about the survey.docx	Yes	Yes	Printable Only
Other-Appendix K.1 Template for email from FNS to State SNAP agency about the case studies	Appendix K.1 Template for email from FNS to State SNAP agency about the case studies.docx	Yes	Yes	Printable Only
Other-Appendix K.2 Template for email from Mathematica to State SNAP agency about the case studies	Appendix K.2 Template for email from Mathematica to State SNAP agency about the case studies.docx	Yes	Yes	Printable Only
Other-Appendix K.4. Case study call script	Appendix K.4. Case study call script.docx	No		Paper Only
Other-Appendix B. SNAP agency survey and document request 2.5.2024	Appendix B. SNAP agency survey and document request 2.5.2024.docx	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 284

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 80 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,361	2,361
Annual IC Time Burden (Hours)	388	388
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix J.4 Template for document reminder email for the survey	Appendix J.4 Template for document reminder email for the survey.docx	11/14/2023
Appendix J.5 Template for biweekly reminder email for SNAP administrators about the survey	Appendix J.5 Template for biweekly reminder email for SNAP administrators about the survey.docx	11/14/2023
Appendix J.6 Template for biweekly reminder email for respondents for the survey	Appendix J.6 Template for biweekly reminder email for respondents for the survey.docx	11/14/2023
Appendix J.7 Urgent reminder email for SNAP administrators about the survey	Appendix J.7 Urgent reminder email for SNAP administrators about the survey.docx	11/14/2023
Appendix J.8 Urgent reminder email for respondents about the survey	Appendix J.8 Urgent reminder email for respondents about the survey.docx	11/14/2023
Appendix J.9 Survey reminder call script	Appendix J.9 Survey reminder call script.docx	11/14/2023
Appendix K.3. Template for sched. reminder email from Mathematica to SNAP State agency for the case studies	Appendix K.3. Template for sched. reminder email from Mathematica to SNAP State agency for the case studies.docx	11/14/2023
Appendix M. Study description	Appendix M. Study description.docx	11/14/2023

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