Information Collection

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

IC 260585 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⚠️ Notice: This information collection may be referencing outdated material.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
CN SF-425.docx fprs.gov Other-CN SF 425 used by all Grantees
CN SF-425.docx fprs.gov Other-CN SF 425 used by all Grantees

Information Collection (IC) Details

View Information Collection (IC)

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

Is this a Common Form? No		IC Status: New

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
Other-CN SF 425 used by all Grantees			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: 53	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	212	212
Annual IC Time Burden (Hours)	1	1
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.