Information Collection

Affidavit Of Return/exchange Of Food Coupons

IC 102971 under ICR 198304-0584-008 · OMB 0584-0052.

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Documents and Forms

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Information Collection (IC) Details

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IC Title:	AFFIDAVIT OF RETURN/EXCHANGE OF FOOD COUPONS	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FNS-135				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5,404	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	90,000	5,556	69,444	15,000
Annual IC Time Burden (Hours)	24,000	1,500	18,750	3,750
Annual IC Cost Burden (Dollars)	0	0	0	0

Documents for IC

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