Information Collection

State, Local and Tribal Agencies

IC 229727 under ICR 202409-0584-001 · OMB 0584-0639.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FNS 886 SNAP Ed Intervention Submission Form State, Local and Tribal Agencies	Form and Instruction
Form FNS 885 SNAP Ed Toolkit Intervention Scoring Tool State, Local and Tribal Agencies	Form and Instruction
Appendix 1 - FNS 885 SNAP-Ed Toolkit Scoring Tool Qualtrics Screenshot Version_01Oct2021.docx snapedtoolkit.org/interventions/submit-an-intervention.	Other-Appendix 1 FNS 885 Screenshot
Appendix 2 - FNS 886 SNAP-Ed Toolkit Intervention Submission Form Qualtrics Screenshot Version_01Oct2021.docx snapedtoolkit.org/interventions/submit-an-intervention.	Other-Appendix 2 - FNS 886 SNAP-Ed T
Appendix C1. FNS-886 Intervention Submission Form Online Survey Screenshot.pdf	Other-FNS 886 Screenshot
FNS 885 SNAP-ED TOOLKIT INTERVENTION SCORING TOOL Appendix 1.1 FNS 885 Final Draft 10-6-2021.rtf	Form and Instruction
FNS 886 SNAP-ED TOOLKIT INTERVENTION SCORING TOOL Appendix 2.1 FNS 886 Final Draft 10-6-2021.rtf snapedtoolkit.org/interventions/submit-an-intervention.	Form and Instruction
FNS 886 SNAP Ed Intervention Submission Form FNS-886 Intervention Submission Form 11.25.24.pdf	Form and Instruction
FNS 885 SNAP Ed Toolkit Intervention Scoring Tool FNS-885 Intervention Scoring Tool 11.25.24.xlsx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 7 CFR § 272.2(2)(d) (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FNS 886	Yes	Yes	Fillable Printable
Form and Instruction	FNS 885	Yes	Yes	Fillable Printable
Other-FNS 886 Screenshot		Yes	Yes	Fillable Printable

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title: FNS-8 USDA/FNS Studies and Reports

FR Citation: 56 FR 19078

Number of Respondents: 37

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	67	14	53
Annual IC Time Burden (Hours)	234	98	136
Annual IC Cost Burden (Dollars)	0	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.

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].