Information Collection

BUSINESS: SNAP E&T Program Providers (Respondents + Pretest)

IC 214461 under ICR 201411-0584-004 · OMB 0584-0602.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0602 can be found here:

Documents and Forms

Document Name Document Type
INSTRUMENT 2_Provider Survey _clean.docx www.notyetcreated.com Other-INSTRUMENT 2_Provider Survey _
INSTRUMENT 2.1_Provider Survey web based 1.12.2015.pdf www.notyetcreated.com Other-INSTRUMENT 2.1_Provider Survey
ATTACHMENT 8_Provider Survey Advance Letter - email_Response 11-26-14.docx ATTACHMENT 8_Provider Survey Advance Letter - email_Response 11-26-14 IC Document
ATTACHMENT 9_Provider Survey Reminder Email_Response 11-26-14.docx ATTACHMENT 9_Provider Survey Reminder Email_Response 11-26-14 IC Document
ATTACHMENT 10_Provider Survey Reminder Postcard 02.25.15.docx ATTACHMENT 10_Provider Survey Reminder Postcard_clean IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	BUSINESS: SNAP E&T Program Providers (Respondents + Pretest)	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-INSTRUMENT 2_Provider Survey _clean			INSTRUMENT 2_Provider Survey _clean.docx	www.notyetcreated.com	Yes	Yes	Fillable Fileable Signable
Other-INSTRUMENT 2.1_Provider Survey web based 1.12.2015			INSTRUMENT 2.1_Provider Survey web based 1.12.2015.pdf	www.notyetcreated.com	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 500	Number of Respondents for Small Entity: 250

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	504	504
Annual IC Time Burden (Hours)	293	293
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
ATTACHMENT 8_Provider Survey Advance Letter - email_Response 11-26-14	ATTACHMENT 8_Provider Survey Advance Letter - email_Response 11-26-14.docx	12/30/2014
ATTACHMENT 9_Provider Survey Reminder Email_Response 11-26-14	ATTACHMENT 9_Provider Survey Reminder Email_Response 11-26-14.docx	12/30/2014
ATTACHMENT 10_Provider Survey Reminder Postcard_clean	ATTACHMENT 10_Provider Survey Reminder Postcard 02.25.15.docx	02/25/2015

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