Information Collection

State & Local Agency Requirements

IC 45202 under ICR 202603-0584-003 · OMB 0584-0541.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix G - FNS-683A SFMNP Closeout Form with Instructions.pdf Appendix G - FNS-683A SFMNP Closeout Form with Instructions	IC Document
Appendix F - FPRS Landing Page and Public Burden Statement.pdf Appendix F: SFMNP State Plan Guidance	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

State & Local Agency Requirements

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 7 CFR 249.10 (b), (e), (f), and (h) 7 CFR 249.11 7 CFR 249.17(b)(2) 7 CFR 249.4 7 CFR 249.3(d) 7 CFR 249.12 7 CFR 249.9 7 CFR 249.18(b) 7 CFR 249.23(a) 7 CFR 249.16(a) 7 CFR 249.6(a)(3)

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 835

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	1,708,254	238,655	1,469,599
Annual IC Time Burden (Hours)	241,229	-138,722	379,951
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix G - FNS-683A SFMNP Closeout Form with Instructions		06/04/2026
Appendix F: SFMNP State Plan Guidance		06/04/2026

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

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