Information Collection

State, Local, and Tribal Governments Respondents

IC 268904 under ICR 202406-0584-003 · OMB 0584-0699.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0699 can be found here:

2024-10-23 - No material or nonsubstantive change to a currently approved collection

Documents and Forms

Document Name Document Type
Attachment D. SNAP State Agency Interview Protocol.docx Other-Attachment D. SNAP State Agenc
Attachment D. SNAP State Agency Interview Protocol.docx Other-Attachment D. SNAP State Agenc
Attachment E. SNAP Local Agency Interview Protocol.docx Other-Attachment E. SNAP Local Agenc
Attachment E. SNAP Local Agency Interview Protocol.docx Other-Attachment E. SNAP Local Agenc
Attachment F. SNAP E&T Provider Interview Protocol.docx Other-Attachment F. SNAP E&T Provide
Attachment F. SNAP E&T Provider Interview Protocol.docx Other-Attachment F. SNAP E&T Provide
Attachment G Interested Parties Interview Protocol .docx Other-Attachment G Interested Partie
Attachment G Interested Parties Interview Protocol .docx Other-Attachment G Interested Partie
Attachment H.1. Notification Email from FNS to States .docx Other-Attachment H.1. Notification E
Attachment H.1. Notification Email from FNS to States .docx Other-Attachment H.1. Notification E
Attachment H3 Email to SNAP State Directors .docx Other-Attachment H.3. Email to SNAP
Attachment H3 Email to SNAP State Directors .docx Other-Attachment H.3. Email to SNAP
Attachment H.5. Document Collection Guide.docx Other-Attachment H.5. Document Colle
Attachment H.5. Document Collection Guide.docx Other-Attachment H.5. Document Colle
Attachment H.13. Interview Scheduling Email 06142024.docx Other- Attachment H.13. Interview Sc
Attachment H.13. Interview Scheduling Email 06142024.docx Other- Attachment H.13. Interview Sc
Attachment H.14. Interview Consent Form 06142024.docx Other-Attachment H.14. Interview Con
Attachment H.14. Interview Consent Form 06142024.docx Other-Attachment H.14. Interview Con
Attachment C. Survey Instrument 08072024.docx Other-Attachment C. Survey Instrumen
Attachment C. Survey Instrument 08072024.docx Other-Attachment C. Survey Instrumen
Attachment H.4. Survey Frequently Asked Questions.docx Attachment H.4. Survey Frequently Asked Questions IC Document
Attachment H.4. Survey Frequently Asked Questions.docx Attachment H.4. Survey Frequently Asked Questions IC Document
Attachment H.2. Overall Project Summary.docx Attachment H.2. Overall Project Summary IC Document
Attachment H.2. Overall Project Summary.docx Attachment H.2. Overall Project Summary IC Document
Attachment H.6 Phone Scripts for Nonresponse Follow-Up.docx Attachment H.6 Phone Scripts for Nonresponse Follow-Up IC Document
Attachment H.6 Phone Scripts for Nonresponse Follow-Up.docx Attachment H.6 Phone Scripts for Nonresponse Follow-Up IC Document
Attachment H.7. Survey Reminder Email.docx Attachment H.7. Survey Reminder Email IC Document
Attachment H.7. Survey Reminder Email.docx Attachment H.7. Survey Reminder Email IC Document
Attachment H.8. Final Survey Reminder Email.docx Attachment H.8. Final Survey Reminder Email IC Document
Attachment H.8. Final Survey Reminder Email.docx Attachment H.8. Final Survey Reminder Email IC Document
Attachment H.9. Survey Thank-You Email.docx Attachment H.9. Survey Thank-You Email IC Document
Attachment H.9. Survey Thank-You Email.docx Attachment H.9. Survey Thank-You Email IC Document
Attachment H.10. Document Reminder Email_clean.docx Attachment H.10. Document Reminder Email_clean IC Document
Attachment H.10. Document Reminder Email_clean.docx Attachment H.10. Document Reminder Email_clean IC Document
Attachment H.11 Confirmation Email to Interview States.docx Attachment H.11 Confirmation Email to Interview States IC Document
Attachment H.11 Confirmation Email to Interview States.docx Attachment H.11 Confirmation Email to Interview States IC Document
Attachment H.12. Interview FAQ 06142024.docx Attachment H.12. Interview FAQ IC Document
Attachment H.12. Interview FAQ 06142024.docx Attachment H.12. Interview FAQ IC Document
Attachment H15 Key Informant Interview Thank You Email.docx Attachment H.15. Key Informant Interview Thank You Email IC Document
Attachment H15 Key Informant Interview Thank You Email.docx Attachment H.15. Key Informant Interview Thank You Email IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	State, Local, and Tribal Governments Respondents	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Attachment D. SNAP State Agency Interview Protocol	Attachment D. SNAP State Agency Interview Protocol.docx	No		Paper Only
Other-Attachment E. SNAP Local Agency Interview Protocol	Attachment E. SNAP Local Agency Interview Protocol.docx	No		Paper Only
Other-Attachment F. SNAP E&T Provider Interview Protocol	Attachment F. SNAP E&T Provider Interview Protocol.docx	No		Paper Only
Other-Attachment G Interested Parties Interview Protocol	Attachment G Interested Parties Interview Protocol .docx	No		Paper Only
Other-Attachment H.1. Notification Email from FNS to States	Attachment H.1. Notification Email from FNS to States .docx	Yes	No	Printable Only
Other-Attachment H.3. Email to SNAP State Directors Launching Surveys	Attachment H3 Email to SNAP State Directors .docx	Yes	No	Printable Only
Other-Attachment H.5. Document Collection Guide	Attachment H.5. Document Collection Guide.docx	Yes	Yes	Fillable Fileable
Other- Attachment H.13. Interview Scheduling Email	Attachment H.13. Interview Scheduling Email 06142024.docx	Yes	No	Printable Only
Other-Attachment H.14. Interview Consent Form	Attachment H.14. Interview Consent Form 06142024.docx	Yes	Yes	Fillable Fileable
Other-Attachment C. Survey Instrument 08072024	Attachment C. Survey Instrument 08072024.docx	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 243	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	1,111	1,111
Annual IC Time Burden (Hours)	308	308
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment H.4. Survey Frequently Asked Questions	Attachment H.4. Survey Frequently Asked Questions.docx	06/21/2024
Attachment H.2. Overall Project Summary	Attachment H.2. Overall Project Summary.docx	06/21/2024
Attachment H.6 Phone Scripts for Nonresponse Follow-Up	Attachment H.6 Phone Scripts for Nonresponse Follow-Up.docx	06/21/2024
Attachment H.7. Survey Reminder Email	Attachment H.7. Survey Reminder Email.docx	06/21/2024
Attachment H.8. Final Survey Reminder Email	Attachment H.8. Final Survey Reminder Email.docx	06/21/2024
Attachment H.9. Survey Thank-You Email	Attachment H.9. Survey Thank-You Email.docx	06/21/2024
Attachment H.10. Document Reminder Email_clean	Attachment H.10. Document Reminder Email_clean.docx	06/21/2024
Attachment H.11 Confirmation Email to Interview States	Attachment H.11 Confirmation Email to Interview States.docx	06/21/2024
Attachment H.12. Interview FAQ	Attachment H.12. Interview FAQ 06142024.docx	06/21/2024
Attachment H.15. Key Informant Interview Thank You Email	Attachment H15 Key Informant Interview Thank You Email.docx	06/21/2024

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