Information Collection

FNS User Access Request Form (State)

IC 184860 under ICR 201411-0584-005 · OMB 0584-0532.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0532 can be found here:

Documents and Forms

Document Name Document Type
Form FNS-674 FNS User Access Request Form (State) Form and Instruction
FNS-674 FNS User Access Request Form FNS-674.pdf www.fns.gov Form and Instruction
FNCS 702 Handbook.pdf FNCS 702 Handbook IC Document
User Guide for Completing the 674 version2 .2.pdf User Guide for Completing the 674 IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	FNS User Access Request Form (State)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 5 CFR 732.101-103

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FNS-674	FNS User Access Request Form	FNS-674.pdf	www.fns.gov	Yes	Yes	Fillable Fileable

Line of Business: Homeland Security

Subfunction: Key Asset and Critical Infrastructure Protection

Privacy Act System of Records
Title: Persons Doing Business with the Food and Nutrition Service	FR Citation: 65 FR 17251

Number of Respondents: 2,520	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	5,040	4,620	0	420
Annual IC Time Burden (Hours)	840	70	700	70
Annual IC Cost Burden (Dollars)	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
FNCS 702 Handbook	FNCS 702 Handbook.pdf	12/18/2014
User Guide for Completing the 674	User Guide for Completing the 674 version2 .2.pdf	12/18/2014

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