Information Collection

ABAWD AMEC/Screening/ Waivers

IC 274933 under ICR 202504-0584-005 · OMB 0584-0479.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Waiver Request Screenshot_0584-0479.jpg	Other-screenshot
Waiver Request Screenshot_0584-0479.jpg	Other-screenshot
Appendix G.1_WIMS Public Burden Statement_0584-0479.jpg	Other-screenshot
Appendix G.1_WIMS Public Burden Statement_0584-0479.jpg	Other-screenshot
Appendix F_ABAWD Request Template_0584-0479_Updated.docx	Instruction
Appendix F_ABAWD Request Template_0584-0479_Updated.docx	Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 7 CFR 7 CFR 273.2(f)(8)(i) 7 CFR 7 CFR 273.2(f)(1), (f)(2)

Information Collection Instruments:

table that charts list of instruments
Document Type	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-screenshot	Yes	Yes	Fillable Printable
Other-screenshot	Yes	Yes	Fillable Printable
Instruction	Yes	Yes	Fillable Printable

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 53

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	29,778,891	29,778,891
Annual IC Time Burden (Hours)	2,016,588	2,016,588
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.

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