OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

FNS-380, Worksheet for the Supplemental Nutrition Assistance Program Quality Control Reviews

ICR 202106-0584-001 · OMB 0584-0074 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
I. Excel Chart for AE64, 0584-0074 FNS 380 Burden Table 4-12-22.xlsx Supplementary Document Uploaded 2022-05-12 Available
H. Burden Narrative 0584-0074 FNS 380 4-30-21cln PRAO comments 6-23-2021cln.docx Supplementary Document Uploaded 2021-06-25 Available
G. FNS-5 REV FNS–5 Info on Persons Disqual from SNAP.pdf Supplementary Document Uploaded 2021-06-25 Available
D. AgImpAct2018-QC provisions.pdf Supplementary Document Uploaded 2021-06-25 Available
C. fna-2008-amended-through-pl-116-94 pgs 105-111.pdf Supplementary Document Uploaded 2021-06-25 Available
OMB 0584-0074 FNS 380 SS Part A 4-21-22 clean.docx Supporting Statement A Uploaded 2022-05-12 Available
OMB 0584-0074 FNS 380 SS Part B 2021 cln.docx Supporting Statement B Uploaded 2021-06-24 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
45873 SNAP Quality Control Review - Household Burden Personal Interviews Modified
2971 SNAP Quality Control Reviews - State Burden Form and Instruction Modified
ICR Details
0584-0074 202106-0584-001
Received in OIRA 201904-0584-003
USDA/FNS RIN 0584-AE64 (Interim Final Rule)
FNS-380, Worksheet for the Supplemental Nutrition Assistance Program Quality Control Reviews
Revision of a currently approved collection   No
Regular 06/07/2022
  Requested Previously Approved
36 Months From Approved 04/30/2023
318,483 318,478
405,996 405,996
0 0
This form provides a systematic means of aiding the State's Quality Control Reviewer in analyzing the case record, planning and doing field investigation and gathering, comparing, analyzing and evaluating data.
PL: Pub.L. 108 - 269 16 Name of Law: Food Stamp Act of 1977
  
PL: Pub.L. 116 - 94 4013 Name of Law: Agricultural Improvement Act 2018
0584-AE64 Final or interim final rulemaking
  86 FR 44575 08/12/2021
87 FR 34233 06/06/2022
No
2
IC Title Form No. Form Name
SNAP Quality Control Review - Household Burden Personal Interviews
SNAP Quality Control Reviews - State Burden FNS 380, FNS 380 Screenshots for FNS 380 Worksheet for Quality Control Reviews ,   FNS 380 Worksheet for Quality Control Reviews
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 318,483 318,478 5 0 0 0
Annual Time Burden (Hours) 405,996 405,996 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$12,773,129
Yes Part B of Supporting Statement
    Yes
    Yes
No
No
No
No
Rachelle Ragland-Greene 703 605-0038 [email protected]
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
06/07/2022