Information Collection

Supplemental Nutrition Assistance Program: Demonstration Projects

IC 276067 under ICR 202506-0584-004 · OMB 0584-0703.

Documents and Forms

Document Name Document Type
Form ESAP ESAP Reporting Template (Change Reporting Supplemental Nutrition Assistance Program: Demonstration Projects Form and Instruction
Form ESAP ESAP Reporting Template (Waive Periodic Report) Supplemental Nutrition Assistance Program: Demonstration Projects Form and Instruction
Form SMD SMD Reporting Template Supplemental Nutrition Assistance Program: Demonstration Projects Form and Instruction
Appendix C Simplified CAP Demo Request Template.docx Instruction
Appendix D ESAP Demo Request Template.docx Instruction
Appendix E SMD Request Template.docx Instruction
Copy of Appendix F CAP-State-Template_Final.xlsx Instruction
ESAP ESAP Reporting Template (Change Reporting Copy of Appendix G ESAP Reporting Template (Change Reporting).xlsx Form and Instruction
ESAP ESAP Reporting Template (Waive Periodic Report) Copy of Appendix I ESAP Reporting Template (Waive Periodic Report).xlsx Form and Instruction
SMD SMD Reporting Template Copy of Appendix J SMD Reporting Template.xlsx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Supplemental Nutrition Assistance Program: Demonstration Projects	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 7 CFR 282

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	ESAP	ESAP Reporting Template (Change Reporting	Copy of Appendix G ESAP Reporting Template (Change Reporting).xlsx	Yes	Yes	Fillable Printable
Form and Instruction	ESAP	ESAP Reporting Template (Waive Periodic Report)	Copy of Appendix I ESAP Reporting Template (Waive Periodic Report).xlsx	Yes	Yes	Fillable Printable
Form and Instruction	SMD	SMD Reporting Template	Copy of Appendix J SMD Reporting Template.xlsx	Yes	Yes	Fillable Printable
Instruction			Appendix C Simplified CAP Demo Request Template.docx	Yes	Yes	Fillable Printable
Instruction			Appendix D ESAP Demo Request Template.docx	Yes	Yes	Fillable Printable
Instruction			Appendix E SMD Request Template.docx	Yes	Yes	Fillable Printable
Instruction			Copy of Appendix F CAP-State-Template_Final.xlsx	Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 53	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	89	89
Annual IC Time Burden (Hours)	16,527	16,527
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.

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