Information Collection

FNS User Access Request Form (State)

IC 184860 under ICR 202407-0584-001 · OMB 0584-0532.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FNS 674 FNS User Access Request Form (State)	Form and Instruction
FNS 674 User Access Request Form Appendix E FNS-674_07252024.pdf	Form and Instruction
FNS 674 User Access Request Form Appendix E_Word Proof_FNS-674_08092024.docx	Form and Instruction
Appendix E User Guide for Completing the 674.pdf Appendix E User Guide for Completing the 674	IC Document
Appendix E User Guide for Completing the 674.pdf Appendix E User Guide for Completing the 674	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 5 CFR 732.101-103

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
Form and Instruction	FNS 674	User Access Request Form	Appendix E_Word Proof_FNS-674_08092024.docx		Yes	Yes	Fillable Printable

Line of Business: Homeland Security

Subfunction: Key Asset and Critical Infrastructure Protection

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 7,020

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	Previously Approved
Annual Number of Responses for this IC	7,020	1,980	5,040
Annual IC Time Burden (Hours)	2,340	1,500	840
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix E User Guide for Completing the 674	Appendix E User Guide for Completing the 674.pdf	04/27/2021

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