Information Collection

SNAP State Agency Performance Reporting Tool

IC 217786 under ICR 201508-0970-002 · OMB 0970-0464.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0464 can be found here:

Documents and Forms

Document Name Document Type
Form 1 SNAP State Agency Performance Reporting Tool Form
2015_SNAP_Performance_Reporting_Instructions.doc Instruction
1 SNAP-Agency NDNH Match Results Performance Reporting Too Copy of 2015_07_15_SNAP-Agency_NDNH_Match_Results_Performance_Reporting_Tool.xls Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	SNAP State Agency Performance Reporting Tool	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	SNAP-Agency NDNH Match Results Performance Reporting Tool	Copy of 2015_07_15_SNAP-Agency_NDNH_Match_Results_Performance_Reporting_Tool.xls		Yes	Yes	Fillable Printable
Instruction			2015_SNAP_Performance_Reporting_Instructions.doc		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 52	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
Annual Number of Responses for this IC	52	52
Annual IC Time Burden (Hours)	85	85
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.