Information Collection

Annual report of State Revenue Matching

IC 2974 under ICR 200711-0584-004 · OMB 0584-0075.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0075 can be found here:

Documents and Forms

Document Name Document Type
Form FNS-13 Annual report of State Revenue Matching Form and Instruction
FNS-13 Annual Report of State Revenue Matching FNS-13.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Annual report of State Revenue Matching	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FNS-13	Annual Report of State Revenue Matching	FNS-13.pdf		Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 57	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 95 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	57	3	54
Annual IC Time Burden (Hours)	4,560	240	4,320
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.