Information Collection

Self-Evaluation Data

IC 203884 under ICR 201208-0584-010 · OMB 0584-0571.

Documents and Forms

Document Name Document Type
Unwritten Information Collection Instrument Placeholder.doc Other-Self Evaluation Data

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Self-Evaluation Data	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-Self Evaluation Data			Unwritten Information Collection Instrument Placeholder.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: 80	Number of Respondents for Small Entity: 8

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	80	80
Annual IC Time Burden (Hours)	160	160
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.