FNS-700 TIP Data Entry Form

FNS 700: TIP Data Entry - Continued

Indicator Information (continued)
Participant Indicators:
L - Participant/other complaints
M - Large number of participants redeeming food instruments outside of their health service area
N - Large number of participants redeeming food instruments who are considered to be at high health risk
O - Large number of food instruments with consecutive serial numbers
P - Large percentage of manually issued food instruments

Other Indicators:
Q - Excessive number of returned checks due to errors
R - Past history of violations and disqualifications
S - Associations with known violators
T - Multiple ownerships which include known violators
U - Short on authorized food items or no inventory
V - New vendor

Sanction Information
All Reason for Sanction choices require that a Type of Sanction be indicated below for all authorized ventdors,
except for reasons that indicate “No Sanction.”

Reason for Sanction:
Check all that apply. However, if you select No Sanction - Warning Letter or No Sanction, no
other boxes can be checked.

T - Trafficking
A - Alcohol/Tobacco
I-

Reimbursement in excess of documented inventory

O - Overcharging
R - Receiving/transacting or redeeming food Instruments outside authorized channels
F - Charging for supplemental food not received
C - Providing credit or non-food items in exchange for Food Instruments
U - Unauthorized food items in exchange for Food Instruments
S - State agency sanction
FSP - Food Stamp Reciprocal Action
W - No Sanction - Warning Letter
N - No Sanction

Type of Sanction:
D - Disqualification (DQ)
C - Civil Money Penalties (CMP)
F - Fine

Administrative Review Information
Administrative Review:
Select One

Pending - P
Upheld - U
Overturned - O
Modified - M
Judicial Review - J

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 range from 5 minutes to 434 hours 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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