Information Collection

State, Local, Tribal Non-Competitive

IC 254042 under ICR 202407-0584-006 · OMB 0584-0512.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0512 can be found here:

2025-12-30 - Revision of a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
FY22 FDPNE RFA On Reservations - Non Comp.docx www.grants.gov	Other-Appendix 38 Food Distribution
FY22 FDPNE RFA On Reservations - Non Comp.docx www.grants.gov	Other-Appendix 38 Food Distribution
FY22 State Plans associated with Non Competitive Grants templete A45 June 23 2022.docx www.grants.gov	Other-A45 State Plans associated wit
FY22 State Plans associated with Non Competitive Grants templete A45 June 23 2022.docx www.grants.gov	Other-A45 State Plans associated wit
FY22 MISC Grants to be authorized by Congress RFA templete. A50 June 23 2022docx.docx www.grants.gov	Other-Appendix 50 Miscellaneous Gran
FY22 MISC Grants to be authorized by Congress RFA templete. A50 June 23 2022docx.docx www.grants.gov	Other-Appendix 50 Miscellaneous Gran
FY22 RFA SNAP leverage SNAP and FST Grant Non Com.docx www.grants.gov	Other-Appendix 42 Supplemental Nutri
FY22 RFA SNAP leverage SNAP and FST Grant Non Com.docx www.grants.gov	Other-Appendix 42 Supplemental Nutri
TransformWICBusinessPracticesImpementationGrants.NC.RFA20222Template (A18 and 43) (June 23 2022).docx www.grants.gov	Other-Appendix 18 and A43 SNAS WIC 3
TransformWICBusinessPracticesImpementationGrants.NC.RFA20222Template (A18 and 43) (June 23 2022).docx www.grants.gov	Other-Appendix 18 and A43 SNAS WIC 3
Modernize the WIC Shopping Experience grocery store non comp business.RFA2022Template.docx www.grants.gov	Other-Appendix 46 SNAS WIC 390 WIC B
Modernize the WIC Shopping Experience grocery store non comp business.RFA2022Template.docx www.grants.gov	Other-Appendix 46 SNAS WIC 390 WIC B
FY22 GrantsWICCVB non competitive Template.docx www.grants.gov	Other-Appendix 44 FY22 GrantsWICCVB
FY22 GrantsWICCVB non competitive Template.docx www.grants.gov	Other-Appendix 44 FY22 GrantsWICCVB
FY22 GrantsWICCVB non competitive business Template.docx www.grants.gov	Other-Appendix 39 FY22 GrantsWICCVB
FY22 GrantsWICCVB non competitive business Template.docx www.grants.gov	Other-Appendix 39 FY22 GrantsWICCVB
HMI Subgrant Final Report Form Example form for A61 June 23-2022.docx www.grants.gov	Other-Appendix 61 FY22.CN Healthy Me
HMI Subgrant Final Report Form Example form for A61 June 23-2022.docx www.grants.gov	Other-Appendix 61 FY22.CN Healthy Me
FY22.CN American Rescue Plan Misc Comp.docx www.grants.gov	Other-Appendix 21 FY22.CN American R
FY22.CN American Rescue Plan Misc Comp.docx www.grants.gov	Other-Appendix 21 FY22.CN American R
FY22 Team Nutrition Training Grant RFA.docx www.grants.gov	Other-Appendix 1 Team Nutrition Trai
FY22 Team Nutrition Training Grant RFA.docx www.grants.gov	Other-Appendix 1 Team Nutrition Trai
FY22.Direct Certification Template.docx www.grants.gov	Other-Appendix 2 FY22.Direct Certifi
FY22.Direct Certification Template.docx www.grants.gov	Other-Appendix 2 FY22.Direct Certifi
FY22.CN TIG Template - FINAL.docx www.grants.gov	Other-Appendix 5 FY22.CN TIG Templat
FY22.CN TIG Template - FINAL.docx www.grants.gov	Other-Appendix 5 FY22.CN TIG Templat
fy2022-RFA_(Farm to School) FST.docx www.grants.gov	Other-Appendix 51 fy2022-RFA_(Farm t
fy2022-RFA_(Farm to School) FST.docx www.grants.gov	Other-Appendix 51 fy2022-RFA_(Farm t
FY22.CN American Rescue Plan non Comp.docx www.grants.gov	Other-Appendix A 40 FY22.CN American
FY22.CN American Rescue Plan non Comp.docx www.grants.gov	Other-Appendix A 40 FY22.CN American
FY22 SNAP American Rescue Plan Misc RFA non comp.docx www.grants.gov	Other-Appendix A41 FY22 SNAP America
FY22 SNAP American Rescue Plan Misc RFA non comp.docx www.grants.gov	Other-Appendix A41 FY22 SNAP America
HMI Subgrant Final Report Form Example form for A61 June 23-2022.docx www.grants.gov	Other-HMI Subgrant Final Report A61F
HMI Subgrant Final Report Form Example form for A61 June 23-2022.docx www.grants.gov	Other-HMI Subgrant Final Report A61F
HMI Subgrant Semi-Annual Progress Report Example form for A61 June 23-2022.docx www.grants.gov	Other-HMI Subgrant Semi-Annual Progr
HMI Subgrant Semi-Annual Progress Report Example form for A61 June 23-2022.docx www.grants.gov	Other-HMI Subgrant Semi-Annual Progr
TransformWICBusinessPracticesImpementationGrants.NC.RFA20222Template.docx www.grants.gov	Other-Appendix A43 Special Supplemen
TransformWICBusinessPracticesImpementationGrants.NC.RFA20222Template.docx www.grants.gov	Other-Appendix A43 Special Supplemen
FY22 WIC- Technology grants NC SLT RFA_Template.docx www.grants.gov	Other-Appendix A56 Special Supplemen
FY22 WIC- Technology grants NC SLT RFA_Template.docx www.grants.gov	Other-Appendix A56 Special Supplemen
Appendix D-4 sf425_2_0-v2.0_fill-sign.pdf www.grants.gov	Other-Appendix D-4 SF-425
Appendix D-4 sf425_2_0-v2.0_fill-sign.pdf www.grants.gov	Other-Appendix D-4 SF-425
Appendix D-4a SF-425 Screenshots.pdf www.fprs.gov	Other-Appendix D-4a SF-425 Screensho
Appendix D-4a SF-425 Screenshots.pdf www.fprs.gov	Other-Appendix D-4a SF-425 Screensho
Appendix D-10 FNS-906.pdf www.grants.gov	Other-Appendix D-10 FNS-906
Appendix D-10 FNS-906.pdf www.grants.gov	Other-Appendix D-10 FNS-906
Appendix D-6 FNS-908_v1.3.pdf www.grants.gov	Other-Appendix D-6 FNS-908
Appendix D-6 FNS-908_v1.3.pdf www.grants.gov	Other-Appendix D-6 FNS-908

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

State, Local, Tribal Non-Competitive

Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Appendix 38 Food Distribution Program on Indian Reservations Nutrition Education (FDPNE) Non Comp Grant Program	FY22 FDPNE RFA On Reservations - Non Comp.docx	www.grants.gov	Yes	Yes	Fillable Fileable Signable
Other-A45 State Plans associated with Non Competitive Grants	FY22 State Plans associated with Non Competitive Grants templete A45 June 23 2022.docx	www.grants.gov	Yes	Yes	Fillable Fileable Signable
Other-Appendix 50 Miscellaneous Grants to be authorized by Congress	FY22 MISC Grants to be authorized by Congress RFA templete. A50 June 23 2022docx.docx	www.grants.gov	Yes	Yes	Fillable Fileable Signable
Other-Appendix 42 Supplemental Nutrition Assistance Program-to Leverage SNAP and FST Non-Competitive	FY22 RFA SNAP leverage SNAP and FST Grant Non Com.docx	www.grants.gov	Yes	Yes	Fillable Fileable Signable
Other-Appendix 18 and A43 SNAS WIC 390 WIC Business Practices and Implement Technology Tools that Improve and Streamline the Participant Experience Implementation Grants, Competitive Program	TransformWICBusinessPracticesImpementationGrants.NC.RFA20222Template (A18 and 43) (June 23 2022).docx	www.grants.gov	Yes	Yes	Fillable Fileable Signable
Other-Appendix 46 SNAS WIC 390 WIC Business Practices and Implement Technology Tools that Improve and Streamline the Participant Experience Implementation Grants, Competitive Program	Modernize the WIC Shopping Experience grocery store non comp business.RFA2022Template.docx	www.grants.gov	Yes	Yes	Fillable Fileable Signable
Other-Appendix 44 FY22 GrantsWICCVB non competitive Template	FY22 GrantsWICCVB non competitive Template.docx	www.grants.gov	Yes	Yes	Fillable Fileable Signable
Other-Appendix 39 FY22 GrantsWICCVB non competitive business Template	FY22 GrantsWICCVB non competitive business Template.docx	www.grants.gov	Yes	Yes	Fillable Fileable Signable
Other-Appendix 61 FY22.CN Healthy Meals Incentive program	HMI Subgrant Final Report Form Example form for A61 June 23-2022.docx	www.grants.gov	Yes	Yes	Fillable Fileable Signable
Other-Appendix 21 FY22.CN American Rescue Plan Misc Comp	FY22.CN American Rescue Plan Misc Comp.docx	www.grants.gov	Yes	Yes	Fillable Fileable Signable
Other-Appendix 1 Team Nutrition Training RFA	FY22 Team Nutrition Training Grant RFA.docx	www.grants.gov	Yes	Yes	Fillable Fileable Signable
Other-Appendix 2 FY22.Direct Certification Template	FY22.Direct Certification Template.docx	www.grants.gov	Yes	Yes	Fillable Fileable Signable
Other-Appendix 5 FY22.CN TIG Template - FINAL	FY22.CN TIG Template - FINAL.docx	www.grants.gov	Yes	Yes	Fillable Fileable Signable
Other-Appendix 51 fy2022-RFA_(Farm to School) FST.docx	fy2022-RFA_(Farm to School) FST.docx	www.grants.gov	Yes	Yes	Fillable Fileable Signable
Other-Appendix A 40 FY22.CN American Rescue Plan non Comp	FY22.CN American Rescue Plan non Comp.docx	www.grants.gov	Yes	Yes	Fillable Fileable Signable
Other-Appendix A41 FY22 SNAP American Rescue Plan Misc RFA non comp.docx	FY22 SNAP American Rescue Plan Misc RFA non comp.docx	www.grants.gov	Yes	Yes	Fillable Fileable Signable
Other-HMI Subgrant Final Report A61Form Example.docx	HMI Subgrant Final Report Form Example form for A61 June 23-2022.docx	www.grants.gov	Yes	Yes	Fillable Fileable Signable
Other-HMI Subgrant Semi-Annual Progress Report Example.docx	HMI Subgrant Semi-Annual Progress Report Example form for A61 June 23-2022.docx	www.grants.gov	Yes	Yes	Fillable Fileable Signable
Other-Appendix A43 Special Supplemental Nutrition Program for Women, Infants, and Children - Transform WIC Business Practices Planning and Implementation Grants	TransformWICBusinessPracticesImpementationGrants.NC.RFA20222Template.docx	www.grants.gov	Yes	Yes	Fillable Fileable Signable
Other-Appendix A56 Special Supplemental Nutrition Program for Women, Infants, and Children - Technology Grants	FY22 WIC- Technology grants NC SLT RFA_Template.docx	www.grants.gov	Yes	Yes	Fillable Fileable Signable
Other-Appendix D-4 SF-425	Appendix D-4 sf425_2_0-v2.0_fill-sign.pdf	www.grants.gov	Yes	Yes	Fillable Fileable Signable
Other-Appendix D-4a SF-425 Screenshots	Appendix D-4a SF-425 Screenshots.pdf	www.fprs.gov	Yes	Yes	Fillable Fileable Signable
Other-Appendix D-10 FNS-906	Appendix D-10 FNS-906.pdf	www.grants.gov	Yes	Yes	Fillable Fileable Signable
Other-Appendix D-6 FNS-908	Appendix D-6 FNS-908_v1.3.pdf	www.grants.gov	Yes	Yes	Fillable Fileable Signable

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title: USDA e-Authentication Service

FR Citation: 71 FR 42346

Number of Respondents: 3,106

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
	Requested	Previously Approved
Annual Number of Responses for this IC	72,899	72,899
Annual IC Time Burden (Hours)	195,401	195,401
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.