Information Collection

Sa & Sfa

IC 202176 under ICR 201311-0584-002 · OMB 0584-0567.

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Information Collection (IC) Details

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IC Title:	SA & SFA	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 7 CFR 210.7(d)(2) 7 CFR 210.7(d)(1)(iv) 7 CFR 210.5(d)(2)(ii)

Information Collection Instruments:

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

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 20,914	Number of Respondents for Small Entity: 627

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	146,204	0	146,204
Annual IC Time Burden (Hours)	156,440	-168	156,608
Annual IC Cost Burden (Dollars)	0	0	0

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