OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Hussc 2012

IC 202851 under ICR 201207-0584-007 · OMB 0584-0524.

Documents and Forms
Document Name
Document Type
Other-FNS-780 2012 HUSSC Bronze-Silv
Other-FNS 779 - 2012 HUSSC Gold-Gold
Other-TN Enrollment Form
IC Document
Information Collection (IC) Details

View Information Collection (IC)

HUSSC 2012
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-FNS-780 2012 HUSSC Bronze-Silver Application rev062712 2012 HUSSC Bronze-Silver Application.doc http://teamnutrition.usda.gov/healthierUS/index.html Yes Yes Paper Only
Other-FNS 779 - 2012 HUSSC Gold-Gold Award of Distinction Application Award of Distinction Application 05222012 rev062712 2012 HUSSC Gold-Gold Award of Distinction Application.doc http://teamnutrition.usda.gov/healthierUS/index.html Yes Yes Paper Only
Other-TN Enrollment Form Attachment C - TN Enrollment Form.doc www.teamnutrition.usda.gov/healthierus/index.html Yes Yes Fillable Fileable Signable

Income Security Food and Nutrition Assistance

 

3,000 300
   
State, Local, and Tribal Governments
 
   100 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 3,000 0 0 0 0 3,000
Annual IC Time Burden (Hours) 2,166 0 0 0 0 2,166
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
HUSSC Generic Clearance Justification rev062612 HUSSC Justification Memo 6-25-12.doc 06/26/2012
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.