Information Collection

(State Agencies) - ABAWD Startup

IC 3082 under ICR 202504-0584-005 · OMB 0584-0479.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix F_ABAWD Request Template_0584-0479_Updated.docx wims.fns.usda.gov	Other-Appendix F_ABAWD Request Templ
Appendix F_ABAWD Request Template_0584-0479_Updated.docx wims.fns.usda.gov	Other-Appendix F_ABAWD Request Templ
Appendix G.1_WIMS Public Burden Statement_0584-0479.jpg wims.fns.usda.gov	Other-Appendix G.1_WIMS Public Burde
Appendix G.1_WIMS Public Burden Statement_0584-0479.jpg wims.fns.usda.gov	Other-Appendix G.1_WIMS Public Burde
Appendix G_WIMS Request Screenshot_0584-0479.jpg wims.fns.usda.gov	Other-Appendix G_WIMS Request Screen
Appendix G_WIMS Request Screenshot_0584-0479.jpg wims.fns.usda.gov	Other-Appendix G_WIMS Request Screen
Appendix C_FNS-366A Screenshot_0584-0479.jpg Appendix C_FNS-366A Screenshot_0584-0479	IC Document
Appendix C_FNS-366A Screenshot_0584-0479.jpg Appendix C_FNS-366A Screenshot_0584-0479	IC Document
Appendix D_FNS-366B Screenshot_0584-0479.jpg Appendix D_FNS-366B Screenshot_0584-0479	IC Document
Appendix D_FNS-366B Screenshot_0584-0479.jpg Appendix D_FNS-366B Screenshot_0584-0479	IC Document
Appendix E_FPRS Public Burden Statement_0584-0479.pdf Appendix E_FPRS Public Burden Statement_0584-0479	IC Document
Appendix E_FPRS Public Burden Statement_0584-0479.pdf Appendix E_FPRS Public Burden Statement_0584-0479	IC Document

IC Title:

Agency IC Tracking Number:

VACATE ABAWD 0584-AE57

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 7 CFR 7 CFR 273.24(c)(7), (8), (9), 7 CFR 273.7(b) 7 CFR 7 CFR 273.24(c) (10), 7 CFR 273.24(k), 7 CFR 273.24(l)

Information Collection Instruments:

table that charts list of instruments
Document Type	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Appendix F_ABAWD Request Template_0584-0479_Updated	https://wims.fns.usda.gov	Yes	Yes	Fillable Fileable Signable
Other-Appendix G.1_WIMS Public Burden Statement_0584-0479	https://wims.fns.usda.gov	Yes	Yes	Fillable Fileable Signable
Other-Appendix G_WIMS Request Screenshot_0584-0479	https://wims.fns.usda.gov	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title: USDA/FNS-10 Entitled Persons Doing Business with the Food and Nutrition Service

FR Citation: 65 FR 17251

Number of Respondents: 105,189

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	105,189	105,154	35
Annual IC Time Burden (Hours)	469,177	468,014	1,163
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix C_FNS-366A Screenshot_0584-0479		12/20/2022
Appendix D_FNS-366B Screenshot_0584-0479		12/20/2022
Appendix E_FPRS Public Burden Statement_0584-0479		12/20/2022

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

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