Information Collection

State Agency E&T Case Managers, Eligibility Workers and Admin Staff

IC 237553 under ICR 202011-0584-003 · OMB 0584-0653.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0653 can be found here:

Documents and Forms

Document Name Document Type
Form FNS 583 State Agency E&T Case Managers, Eligibility Workers and Admin Staff Form and Instruction
FNS 583 SNAP E&T Report FNS-583 Screenshots.pdf www.fprs.gov Form and Instruction
FNS 583 SNAP E&T Report FNS-583 Screenshots.pdf www.fprs.gov Form and Instruction
0584-0594 FPRS PBStatement _ExpDatDisplayed 9-30-2019.pdf 0584-0594 FPRS PBS for FNS 583 IC Document
0584-0594 FPRS PBStatement _ExpDatDisplayed 9-30-2019.pdf 0584-0594 FPRS PBS for FNS 583 IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	State Agency E&T Case Managers, Eligibility Workers and Admin Staff	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 7 CFR 273.7(c)(1) 7 CFR 273.7(a)(5) 7 CFR 273.7(c)(11) 7 CFR 273.7(c)(18)(i)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FNS 583	SNAP E&T Report	FNS-583 Screenshots.pdf	www.fprs.gov	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: 53	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	5,754,509	5,754,509
Annual IC Time Burden (Hours)	1,093,281	1,093,281
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
0584-0594 FPRS PBS for FNS 583	0584-0594 FPRS PBStatement _ExpDatDisplayed 9-30-2019.pdf	08/27/2019

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