Monthly Claim for Reimbursement

ICR 200308-0584-002

OMB: 0584-0284

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
3005 Migrated
ICR Details
0584-0284 200308-0584-002
Historical Active 200301-0584-007
USDA/FNS
Monthly Claim for Reimbursement
Reinstatement with change of a previously approved collection   No
Regular
Approved with change 11/18/2003
Retrieve Notice of Action (NOA) 08/22/2003
For the next information collection, FNS will explore the potential benefits of collecting information about the quantities of the types of milks states are reimbursed for (i.e. whole, 1%, skim, etc), to further inform FNS nutritional policy making. As per FNS's fax on 11/17/03, the reimbursement form will only be available electronically; however, FNS will print out the electronic version upon request for clients who require a paper copy.
  Inventory as of this Action Requested Previously Approved
11/30/2006 11/30/2006
2,090 0 0
1,735 0 0
0 0 0

To fulfill the earned reimbursement requirements set forth in the National School Lunch, Breakfast and Milk regulation issued by the Secretary of Agriculture (Parts 210.8 220.11 & 215.10)

None
None


No

1
IC Title Form No. Form Name
Monthly Claim for Reimbursement 806-A, 806-B

  Total Approved Previously Approved 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 2,090 0 0 2,090 0 0
Annual Time Burden (Hours) 1,735 0 0 1,735 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
08/22/2003


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