Information Collection

Individuals/Households (OMB control number 0584-0074) REVISED FOR AE79

IC 238228 under ICR 201909-0584-003 · OMB 0584-0692.

Documents and Forms

Document Name Document Type
I- SORN FNS KC- 00-8005.pdf SORNS IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Individuals/Households (OMB control number 0584-0074) REVISED FOR AE79	Agency IC Tracking Number:	Rev for only the hours needed for the merge

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 7 CFR 275.12 (c)(1)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title: USDA.FNS-5 Information on Persons Disqualified from the Supplemental Nutrition Assistance Program	FR Citation: 75 FR 81205

Number of Respondents: 59,146	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	59,146	59,146
Annual IC Time Burden (Hours)	29,573	29,573
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SORNS	I- SORN FNS KC- 00-8005.pdf	10/03/2023

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