Information Collection

State/Local: F - Certified and Denied Applicant Sampling

IC 203782 under ICR 201208-0584-008 · OMB 0584-0530.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0530 can be found here:

Documents and Forms

Document Name Document Type
rev062112 Attachment F.1-Student Sample Contact Info Form.docm Other-F.1-Student Sample Contact Inf
rev062112 Attachment F.2-Newly Cert FRP.doc Other-F.2-Newly Cert FRP

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	State/Local: F - Certified and Denied Applicant Sampling	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-F.1-Student Sample Contact Info Form			rev062112 Attachment F.1-Student Sample Contact Info Form.docm		No		Paper Only
Other-F.2-Newly Cert FRP			rev062112 Attachment F.2-Newly Cert FRP.doc		No		Paper Only

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title: FNS Studies and Reports	FR Citation: 56 FR 19078

Number of Respondents: 124	Number of Respondents for Small Entity: 12

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	248	248
Annual IC Time Burden (Hours)	62	62
Annual IC Cost Burden (Dollars)	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.