FNS-698, pg. 3 Profile of Integrity Practices and Procedures (PIPP)

FNS 698: PIPP - Continued
FNS-698 - OMB Form Number: 0584-0401
SECTION 3: Food Instruments
FI = Food Instrument
1 The food instrument used is:
Check all that apply

CHECK
VOUCHER
DRAFT
EBT CARD
2

(a negotiable FI which is processed for payment through the vendor's bank)
(a non-negotiable FI which is processed for payment through the State Agency)
(a negotiable FI which is processed for payment through a fiscal intermediary)

Food instruments are generally issued:
Check only one box

Monthly
Every 2 months
Every 3 months
Other (specify below)
Other time period:
Enter Data

Average number of food instruments:

3

Enter the average number of food instruments
issued per participant per month:
Enter Data
4

The maximum value on the food instrument is hidden:
Select One
Yes
No

5

Food instruments are routinely mailed to participants:
Mailed statewide or in certain areas on a routine basis. (Do not check Yes if FI's are routine mailed for inclement weather.)

Select One
Yes
No

According to the Paperwork Reduction Act of 1995, no persons are 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 0584-0401. The time
required for completing this collection is estimated to take 10 minutes per response, including the time for
Reviewing instructions, searching existing data sources, gathering the data needed, and completing and reviewing the
information collection.

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