Fns-798a Addendum To Wic Financial Mangement And Participation Re

											Attachment 2
FORM APPROVED OMB NO. 0584-0045
U.S. DEPARTMENT OF AGRICULTURE - Food and Nutrition Service
ADDENDUM TO WIC FINANCIAL MANAGEMENT AND PARTICIPATION REPORT - NSA EXPENDITURES
Public reporting burden for this collection of information is estimated to average 1.7 hours 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. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to: U.S. Department of Agriculture, Food and Nutrition Services, Office of Research, Nutrition and Analysis, Alexandria, VA 22302 (0584-0054). Do not return the completed form to this address.
1. STATE AGENCY NAME				2. 7 - DIGIT CODE						3. PERIOD COVERED
				4. FISCAL YEAR
STATE LEVEL EXPENDITURES					LOCAL LEVEL EXPENDITURES
5. FUNCTIONS/     ACTIVITIES		01  GENERAL ADMIN	02  CLIENT SERVICES	03  NUTRITION EDUCATION	04  BREAST FEEDING	05  GENERAL ADMIN	06  CLIENT SERVICES	07  NUTRITION EDUCATION	08  BREAST FEEDING	09   TOTAL
a. TOTAL FEDERAL     OUTLAYS
b. TOTAL STATE     OUTLAYS     (OPTIONAL)
6. INDIRECT EXPENSE AMOUNT:							Signature of Certifying Official
							Name and Title
							Date Report Submitted			Telephone Number (Include Area Code)
REMARKS:
STAMP/CERTIFY DATE			LAST UPDATED BY				LAST UPDATED ON
FORM FNS-798 (7-02)							Printed on 05/12/2008 10:12:24 AM
FPRS Electronic Version							Page 1 of 1