FNS User Access Request Form (State)

The FNS User Access Request Form Data Collection

Documents and Forms

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

Information Collection (IC) Details

IC Title:	FNS User Access Request Form (State)	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:

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 %

	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

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.