Information Collection

Individuals and Households

IC 253895 under ICR 202205-0584-005 · OMB 0584-0675.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0675 can be found here:

Documents and Forms

Document Name Document Type
Appendix H. Observation Guide.docx Other-Appendix H. Observation Guide
Appendix H. Observation Guide.docx Other-Appendix H. Observation Guide

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Individuals and Households	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Appendix H. Observation Guide			Appendix H. Observation Guide.docx		No		Paper Only

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 24	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	24	24
Annual IC Time Burden (Hours)	12	12
Annual IC Cost Burden (Dollars)	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.