Information Collection

OMB# 4040-0014 SF 425 (CN/SNAP/FD/FDPNE/WIC/Pandemic/PAN SLT

IC 204616 under ICR 202303-0584-001 · OMB 0584-0594.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0594 can be found here:

Documents and Forms

Document Name Document Type
Form SF 425 (screenshot OMB# 4040-0014 SF 425 (CN/SNAP/FD/FDPNE/WIC/Pandemic/PAN SLT Form and Instruction
SF-425 and instructions.pdf fprs.fns.usda.gov Instruction
SF-425 and instructions.pdf fprs.fns.usda.gov Instruction
CN SF-425.docx fprs.gov Other-CN Administrative Review & Tra
CN SF-425.docx fprs.gov Other-CN Administrative Review & Tra
SF 425 (screenshot Federal Financial Report CN-ARTMII_SF-425_Report_1.jpg fprs.fns.usda.gov Form and Instruction
SF 425 (screenshot Federal Financial Report CN-ARTMII_SF-425_Report_1.jpg fprs.fns.usda.gov Form and Instruction
SF 425 (screenshot Federal Financial Report CN-ARTMII_SF-425_Report_2.jpg www.fprs.gov Form and Instruction
SF 425 (screenshot Federal Financial Report CN-ARTMII_SF-425_Report_2.jpg www.fprs.gov Form and Instruction
SF 425 Screenshots Federal Financial Report CN-ARTMII_SF-425_Remarks.jpg www.fprs.gov Form and Instruction
SF 425 Screenshots Federal Financial Report CN-ARTMII_SF-425_Remarks.jpg www.fprs.gov Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	OMB# 4040-0014 SF 425 (CN/SNAP/FD/FDPNE/WIC/Pandemic/PAN SLT	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SF 425 (screenshot page 1)	Federal Financial Report	CN-ARTMII_SF-425_Report_1.jpg	https://fprs.fns.usda.gov	Yes	Yes	Fillable Fileable Signable
Instruction			SF-425 and instructions.pdf	https://fprs.fns.usda.gov	Yes	Yes	Fillable Fileable Signable
Form and Instruction	SF 425 (screenshot page 2)	Federal Financial Report	CN-ARTMII_SF-425_Report_2.jpg	www.fprs.gov	Yes	Yes	Fillable Fileable Signable
Form and Instruction	SF 425 Screenshots (remarks section)	Federal Financial Report	CN-ARTMII_SF-425_Remarks.jpg	www.fprs.gov	Yes	Yes	Fillable Fileable Signable
Other-CN Administrative Review & Training			CN SF-425.docx	https://fprs.gov	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 150	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	6,050	-1,889	-2,416	10,355
Annual IC Time Burden (Hours)	22,351	10,442	-3,624	15,533
Annual IC Cost Burden (Dollars)	0	0	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.