View Information Collection (IC)

View Information Collection (IC)

IC Title:	State, Local, or Tribal Government	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-B. SNAP Agency Data Request			B. SNAP Agency Data Request.docx		Yes	No	Printable Only
Other-I. Police Station Letter			I. Police Station Letter.docx		No		Paper Only
Other-R. Study Description			R. Study Description.docx		Yes	No	Printable Only
Other-Q1. Focus Group Consent Form			Q1. Focus Group Consent Form.docx		Yes	Yes	Printable Only
Other-Q3. Focus Group Invitation			Q3. Focus Group Invitation.docx		Yes	No	Printable Only
Other-Q2. Focus Group Discussion Guide			Q2. Focus Group Discussion Guide.docx		No		Paper Only

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: 50	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 New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	117	0	117	0	0	0
Annual IC Time Burden (Hours)	77	0	77	0	0	0
Annual IC Cost Burden (Dollars)	0	0	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.