State Government Responsive

How States Safeguard Supplemental Nutrition Assistance Program Participant's Personally Identifiable Information (PII) (New)

Appendix B.2 Online Survey

State Government Responsive

OMB: 0584-0666

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Appendix B.2 Survey of SNAP State Agencies (Online Version)

Note: This survey incorporates branching logic where differing section introductions and questions will be displayed depending upon whether the respondent is from a State- or County- Administered SNAP agency. In those instances of branching, the section introduction or question for State-Administered SNAP agencies appears first while the corresponding version for County-Administered SNAP agencies follows. The same question will be displayed for both agency types unless specifically identified as a “State-Administered Screenshot” or “County-Administered Screenshot”.


According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0584-XXXX. The time required to complete this information collection is estimated to average 60 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.



State-Administered Screenshot



County-Administered Screenshot










County-Administered Only Screenshot

(this question will not be asked of State-Administered agencies)





State-Administered Screenshot

County-Administered Screenshot











State-Administered Screenshot

County-Administered Screenshot






State-Administered Screenshot

County-Administered Screenshot

State-Administered Screenshot



County-Administered Screenshot



State-Administered Screenshot

County-Administered Screenshot

State-Administered Screenshot

County-Administered Screenshot





State-Administered Screenshot

County-Administered Screenshot



State-Administered Screenshot



County-Administered Screenshot



State-Administered Screenshot

County-Administered Screenshot

State-Administered Screenshot


County-Administered Screenshot

State-Administered Screenshot


County-Administered Screenshot

State-Administered Screenshot



County-Administered Screenshot



State-Administered Screenshot


County-Administered Screenshot

State-Administered Screenshot


County-Administered Screenshot

State-Administered Screenshot


County-Administered Screenshot


State-Administered Screenshot



County-Administered Screenshot


State-Administered Screenshot



County-Administered Screenshot



State-Administered Screenshot

County-Administered Screenshot

State-Administered Screenshot

County-Administered Screenshot


State-Administered Screenshot


County-Administered Screenshot



State-Administered Screenshot


County-Administered Screenshot



Note: The screenshots below illustrate how the text box will appear after a respondent makes a selection.




State-Administered Screenshot

County-Administered Screenshot

State-Administered Screenshot



County-Administered Screenshot



State-Administered Screenshot

County-Administered Screenshot






















OMB Number: 0584-#### 1231981BF0081 | Appendix B-80

Expiration Date: ##/##/####

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleSNAP PII: Office of Management and Budget Information Collection Review Package
Subject1231981BF0081
AuthorAndrés Romualdo, MA
File Modified0000-00-00
File Created2021-02-06

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