Information Collection

State, Local, and Tribal Governments Respondents

IC 268904 under ICR 202406-0584-003 · OMB 0584-0699.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0699 can be found here:

2024-10-23 - No material or nonsubstantive change to a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment D. SNAP State Agency Interview Protocol.docx	Other-Attachment D. SNAP State Agenc
Attachment D. SNAP State Agency Interview Protocol.docx	Other-Attachment D. SNAP State Agenc
Attachment E. SNAP Local Agency Interview Protocol.docx	Other-Attachment E. SNAP Local Agenc
Attachment E. SNAP Local Agency Interview Protocol.docx	Other-Attachment E. SNAP Local Agenc
Attachment F. SNAP E&T Provider Interview Protocol.docx	Other-Attachment F. SNAP E&T Provide
Attachment F. SNAP E&T Provider Interview Protocol.docx	Other-Attachment F. SNAP E&T Provide
Attachment G Interested Parties Interview Protocol .docx	Other-Attachment G Interested Partie
Attachment G Interested Parties Interview Protocol .docx	Other-Attachment G Interested Partie
Attachment H.1. Notification Email from FNS to States .docx	Other-Attachment H.1. Notification E
Attachment H.1. Notification Email from FNS to States .docx	Other-Attachment H.1. Notification E
Attachment H3 Email to SNAP State Directors .docx	Other-Attachment H.3. Email to SNAP
Attachment H3 Email to SNAP State Directors .docx	Other-Attachment H.3. Email to SNAP
Attachment H.5. Document Collection Guide.docx	Other-Attachment H.5. Document Colle
Attachment H.5. Document Collection Guide.docx	Other-Attachment H.5. Document Colle
Attachment H.13. Interview Scheduling Email 06142024.docx	Other- Attachment H.13. Interview Sc
Attachment H.13. Interview Scheduling Email 06142024.docx	Other- Attachment H.13. Interview Sc
Attachment H.14. Interview Consent Form 06142024.docx	Other-Attachment H.14. Interview Con
Attachment H.14. Interview Consent Form 06142024.docx	Other-Attachment H.14. Interview Con
Attachment C. Survey Instrument 08072024.docx	Other-Attachment C. Survey Instrumen
Attachment C. Survey Instrument 08072024.docx	Other-Attachment C. Survey Instrumen
Attachment H.4. Survey Frequently Asked Questions.docx Attachment H.4. Survey Frequently Asked Questions	IC Document
Attachment H.4. Survey Frequently Asked Questions.docx Attachment H.4. Survey Frequently Asked Questions	IC Document
Attachment H.2. Overall Project Summary.docx Attachment H.2. Overall Project Summary	IC Document
Attachment H.2. Overall Project Summary.docx Attachment H.2. Overall Project Summary	IC Document
Attachment H.6 Phone Scripts for Nonresponse Follow-Up.docx Attachment H.6 Phone Scripts for Nonresponse Follow-Up	IC Document
Attachment H.6 Phone Scripts for Nonresponse Follow-Up.docx Attachment H.6 Phone Scripts for Nonresponse Follow-Up	IC Document
Attachment H.7. Survey Reminder Email.docx Attachment H.7. Survey Reminder Email	IC Document
Attachment H.7. Survey Reminder Email.docx Attachment H.7. Survey Reminder Email	IC Document
Attachment H.8. Final Survey Reminder Email.docx Attachment H.8. Final Survey Reminder Email	IC Document
Attachment H.8. Final Survey Reminder Email.docx Attachment H.8. Final Survey Reminder Email	IC Document
Attachment H.9. Survey Thank-You Email.docx Attachment H.9. Survey Thank-You Email	IC Document
Attachment H.9. Survey Thank-You Email.docx Attachment H.9. Survey Thank-You Email	IC Document
Attachment H.10. Document Reminder Email_clean.docx Attachment H.10. Document Reminder Email_clean	IC Document
Attachment H.10. Document Reminder Email_clean.docx Attachment H.10. Document Reminder Email_clean	IC Document
Attachment H.11 Confirmation Email to Interview States.docx Attachment H.11 Confirmation Email to Interview States	IC Document
Attachment H.11 Confirmation Email to Interview States.docx Attachment H.11 Confirmation Email to Interview States	IC Document
Attachment H.12. Interview FAQ 06142024.docx Attachment H.12. Interview FAQ	IC Document
Attachment H.12. Interview FAQ 06142024.docx Attachment H.12. Interview FAQ	IC Document
Attachment H15 Key Informant Interview Thank You Email.docx Attachment H.15. Key Informant Interview Thank You Email	IC Document
Attachment H15 Key Informant Interview Thank You Email.docx Attachment H.15. Key Informant Interview Thank You Email	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

State, Local, and Tribal Governments 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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Attachment D. SNAP State Agency Interview Protocol	No		Paper Only
Other-Attachment E. SNAP Local Agency Interview Protocol	No		Paper Only
Other-Attachment F. SNAP E&T Provider Interview Protocol	No		Paper Only
Other-Attachment G Interested Parties Interview Protocol	No		Paper Only
Other-Attachment H.1. Notification Email from FNS to States	Yes	No	Printable Only
Other-Attachment H.3. Email to SNAP State Directors Launching Surveys	Yes	No	Printable Only
Other-Attachment H.5. Document Collection Guide	Yes	Yes	Fillable Fileable
Other- Attachment H.13. Interview Scheduling Email	Yes	No	Printable Only
Other-Attachment H.14. Interview Consent Form	Yes	Yes	Fillable Fileable
Other-Attachment C. Survey Instrument 08072024	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: 243

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	1,111	1,111
Annual IC Time Burden (Hours)	308	308
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment H.4. Survey Frequently Asked Questions		06/21/2024
Attachment H.2. Overall Project Summary		06/21/2024
Attachment H.6 Phone Scripts for Nonresponse Follow-Up		06/21/2024
Attachment H.7. Survey Reminder Email		06/21/2024
Attachment H.8. Final Survey Reminder Email		06/21/2024
Attachment H.9. Survey Thank-You Email		06/21/2024
Attachment H.10. Document Reminder Email_clean		06/21/2024
Attachment H.11 Confirmation Email to Interview States		06/21/2024
Attachment H.12. Interview FAQ		06/21/2024
Attachment H.15. Key Informant Interview Thank You Email		06/21/2024

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

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