Information Collection

Business for-not-for-Profit (Respondents)

IC 233042 under ICR 201806-0584-003 · OMB 0584-0645.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0645 can be found here:

Documents and Forms

Document Name Document Type
I. Observation Checklist.docx Other-I. Observation Checklist.docx
K. E&T Provider Interview Protocol.docx Other-K. E&T Provider Interview Prot
L. Admin Data Submission Instructions and Variable List.docx Instruction
M.1. FTP Site instructions for submitting administrative data.docx snap.insightpolicyresearch.com Other-M.1. FTP Site instructions for
J. Client Consent Form for Observations.docx J. Client Consent Form for Observations.docx IC Document
M.2. Email to States with FTP Password.docx M.2. Email to States with FTP Password.docx IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Business for-not-for-Profit (Respondents)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-I. Observation Checklist.docx	I. Observation Checklist.docx		No		Paper Only
Other-K. E&T Provider Interview Protocol.docx	K. E&T Provider Interview Protocol.docx		No		Paper Only
Instruction	L. Admin Data Submission Instructions and Variable List.docx		No		Paper Only
Other-M.1. FTP Site instructions for submitting administrative data.docx	M.1. FTP Site instructions for submitting administrative data.docx	http://snap.insightpolicyresearch.com	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title: USDA/FNS-10 Persons Doing Business with FNS	FR Citation: 65 FR 17251

Number of Respondents: 52	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	70	70
Annual IC Time Burden (Hours)	83	83
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
J. Client Consent Form for Observations.docx	J. Client Consent Form for Observations.docx	09/18/2018
M.2. Email to States with FTP Password.docx	M.2. Email to States with FTP Password.docx	09/18/2018

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