Information Collection

Food Stamp Nutrition Connection Resource Sharing Form (Private)

IC 1016 under ICR 201705-0584-008 · OMB 0584-0625.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0625 can be found here:

Documents and Forms

Document Name Document Type
NAL - SNAP_edForm for Collection 0518-0031.pdf snap.nal.usda.gov/resource-library/sharing-center/submission-form Other-SNAP-Ed Connection Submission

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Food Stamp Nutrition Connection Resource Sharing Form (Private)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 7 CFR 2.65

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-SNAP-Ed Connection Submission Form			NAL - SNAP_edForm for Collection 0518-0031.pdf	http://snap.nal.usda.gov/resource-library/sharing-center/submission-form	Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 80	Number of Respondents for Small Entity: 5

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

Percentage of Respondents Reporting Electronically: 95 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	320	300	20
Annual IC Time Burden (Hours)	55	49	6
Annual IC Cost Burden (Dollars)	0	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.