State Agency Reviewers Reporting FNS 380 - OMB 0584-0074 Start-up Burden and ongoing recordkeeping REVISED FOR AE79

RIN 0584-AE79 Reform Provisions for the Supplemental Nutrition Assistance Program’s Quality Control System

Documents and Forms

Document Name Document Type
Form FNS 380 State Agency Reviewers Reporting FNS 380 - OMB 0584-0074 Start-up Burden and ongoing recordkeeping REVISED FOR AE79 Form and Instruction
Form FNS 380 State Agency Reviewers Reporting FNS 380 - OMB 0584-0074 Start-up Burden and ongoing recordkeeping REVISED FOR AE79 Form and Instruction
FNS 380 WORKSHEET FOR QUALITY CONTROL REVIEWS F- FNS-380 with Instructions ex 7-31-2025.pdf snapqcs.fns.usda.gov/ Form and Instruction
D- October 2021 FNS Handbook 310- Revised_Feb 2022.pdf Appendix D FNS 310 Handbook IC Document
H- SNAPQCS PIA.pdf Appendix H - SNAPQCS PIA for 0074 IC Document

Information Collection (IC) Details

IC Title:	State Agency Reviewers Reporting FNS 380 - OMB 0584-0074 Start-up Burden and ongoing recordkeeping REVISED FOR AE79	Agency IC Tracking Number:	Rev for only the hours needed for the merge

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 7 CFR 275.12 7 CFR 275.12 (b) 7 CFR 275.12 and 275.21 (b)(1) 7 CFR 275.12 (d)(3) 7 CFR 275.12(d)(1) 7 CFR 275.12(e)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FNS 380	WORKSHEET FOR QUALITY CONTROL REVIEWS	F- FNS-380 with Instructions ex 7-31-2025.pdf	https://snapqcs.fns.usda.gov/	Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title: USDA.FNS-5 Information on Persons Disqualified from the Supplemental Nutrition Assistance Program	FR Citation: 75 FR 81205

Number of Respondents: 687	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	710,390	710,390
Annual IC Time Burden (Hours)	553,187	553,187
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Appendix D FNS 310 Handbook	D- October 2021 FNS Handbook 310- Revised_Feb 2022.pdf	10/03/2023
Appendix H - SNAPQCS PIA for 0074	H- SNAPQCS PIA.pdf	10/03/2023

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