This script is used to control the display of information in this page.
Display additional information by clicking on the following:
Brief and OIRA conclusion
Common Form Info.
View Information Collection (IC) List
View Supporting Statement and Other Documents
Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
ICR Reference No:
Previous ICR Reference No:
Agency Tracking No:
E&C Final Rule
Food Stamp Forms: Applications, Periodic Reporting, Notices
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
Type of Review Request:
OIRA Conclusion Action:
Approved without change
Retrieve Notice of Action (NOA)
Date Received in OIRA:
Terms of Clearance:
Inventory as of this Action
36 Months From Approved
Time Burden (Hours)
Cost Burden (Dollars)
Information collected is used to determine eligibility and participation in the food stamp program. Certifications and periodic reporting are to verify current eligibility.
Pub.L. 104 - 208 Title I
Name of Law: Omnibus Consoidated Appropriations Act
Pub.L. 105 - 185 Title IV
Name of Law: Ag Research, Extension, & Education Reform Act of 1998
Pub.L. 108 - 267 3, 5, 11
Name of Law: The Food Stamp Act of 1977
Pub.L. 107 - 171 Title IV Subtitle A
Name of Law: FSRIA 2002
Pub.L. 104 - 193 Title IV
Name of Law: PRWORA
Citations for New Statutory Requirements:
Associated Rulemaking Information
Stage of Rulemaking:
Federal Register Citation:
Final or interim final rulemaking
75 FR 19
Federal Register Notices & Comments
Federal Register Citation:
69 FR 20724
Did the Agency receive public comments on this ICR?
Number of Information Collection (IC) in this ICR:
Household/Individual: Application & Periodic Reporting
Local Agencies Recordkeeping
State: Applications, Periodic Reporting, Notices
ICR Summary of Burden
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
Annual Time Burden (Hours)
Annual Cost Burden (Dollars)
Burden increases because of Program Change due to Agency Discretion:
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
Burden Reduction Due to:
This is a revision of a currently approved data collection. The changes in the information collection burden reflect the changes contained in the final rule Food Stamp Program: Eligibility and Certification Provisions of the Farm Security and Rural Investment Act of 2002 as well as those changes resulting changes in State policy and caseload growth. The current burden for 0584-0064 is 23,642,768 which have increased by 1,250,579 [0584-0496 increased by 236 hours and 0584-0083 increased by 40 hours for a total of 1,250,855 for this request (due to the FSRIA Final Rule)] for a total of 24,893,623 burden hours for 0584-0064.
Annual Cost to Federal Government:
Does this IC contain surveys, censuses, or employ statistical methods?
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
Anne Bartholomew 703 305-2017 Anne.Bartholowme@fns.usda.gov
Common Form ICR:
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.