Form FNS-7 DESTINATION DATA FOR DELIVERY OF DESTINATION DATA FOR DE

FORM APPROVED OMB NO. 0584-0293
Expiration Date XX-2009
U.S. DEPARTMENT OF AGRICULTURE - FOOD AND NUTRITION SERVICE

DESTINATION DATA FOR DELIVERY OF
DONATED FOODS

TYPE OF ACTION
CHANGE

NEW

FNS Instruction 709 -5
SEE INSTRUCTIONS ON REVERSE

DELETE

Public reporting burden for this collection of information is estimated to average 30 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. 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 this burden, to: U.S.
Department of Agriculture, Food and Nutrition Services, Office of Research and Analysis (0584-0293), Alexandria, VA 22302. Do not return the completed form to this address.

1. NAME OF STATE DISTRIBUTING AGENCY

2. DESTINATION (CITY) RECEIVING POINT

4. CONSIGN TO

5. CARE OF (Please provide Fax No. and E-mail address if available)

3. STATE IN WHICH DISTRIBUTING AGENCY
IS LOCATED

ENTITY NO.
6. DELIVER TO (Street address, team track, warehouse, etc.

Please provide Fax and E-Mail address if available)

A. FOR RAIL DELIVERY

LIMITATIONS

B. FOR TRUCK DELIVERY

LIMITATIONS

EXPLANATION OF NEED FOR THE RESTRICTION SHOWN

7. SHIP BY (Shipment may be made by rail or truck
unless one of the following is checked)
TRUCK ONLY

RAIL ONLY

8. TITLE AND ADDRESS ONLY OF PERSON TO WHOM THE FORWARDING
NOTICE AND DISTRIBUTION AGENCY CONSIGNEE RECEIPT (Form
MP-209A) SHOULD BE SENT

9. TITLE AND ADDRESS ONLY OF PERSON TO WHOM THE NOTICE OF SHIPMENT
SHOULD BE SENT

10. OUTLET(S) SERVED
NUTRITION PROGRAM FOR
THE ELDERLY (NPE)

CHARITABLE INSTITUTIONS

CHILD AND ADULT
CARE FOOD PROGRAM
(CACFP)

SUMMER CAMPS

COMMODITY SUPPLEMENTAL
FOOD PROGRAM (CSFP)

SUMMER FOOD SERVICE
PROGRAM

FOOD DIST. PRGM. ON
INDIAN RESERVATIONS
(FDPIR)

OTHER (Specify)

SCHOOLS

THE EMERGENCY FOOD
ASSISTANCE PROGRAM (TEFAP)

IF DESTINATION IS A WAREHOUSE, COMPLETE ITEMS 1 1 THROUGH 1 4
12. IF COMMERCIAL WAREHOUSE DELIVERY ACCEPTABLE BY

11. TYPE OF WAREHOUSE
STATE OWNED AND OPERATED

COMMERCIAL

TRANSFER OF TITLE

13. TYPE(S) OF STORAGE PROVIDED

DRY

LOCAL PICKUP

14. HANDLING OF PERISHABLE FOODS (Check one)

REFRIGERATED

SHIPMENT ALWAYS ENTIRELY UNLOADED AND PLACED IN STORAGE
PART OF SHIPMENT ALWAYS OR SOMETIMES DISTRIBUTED FROM CAR OR
WAREHOUSE PLATFORM

FREEZER

The above information is true and correct to the best of my knowledge and belief.
16. SIGNATURE OF AGENCY REPRESENTATIVE

15. DATE

DESTINATION

DISTRIBUTING
AGENCY

- Send a fax/copy to the Food and Nutrition Service Regional Office.

FNS REGIONAL OFFICE - Send a fax/copy to the Kansas City Commodity Office.
FORM FNS-7 (07/08) Previous editions obsolete

SBU

Electronic Form Version Designed in Adobe 8.1 Version

INSTRUCTIONS
It is important that a separate form be prepared for each
destination (item 2) when delivery conditions require
changes in elements of information in items 5, 6, 7, 8, or 9.

effect at the point of delivery, the name of the railroad
which serves this location shall be shown. For example:
"Blank's Warehouse, ACL," or "Industrial siding, PPP."
Where reciprocal switching is in effect at the point of
delivery, no delivering carrier shall be specified. If delivery
is to be made on a team track, the name of a specific team
track shall not be shown unless it is essential to program
requirements.

In the "Type of Action" entry, check one box only
indicating whether the form is to provide data for: (1) a
New destination, (2) notification of CHANGE in data for
an existing receiving point, or (3) DELETION of a
destination receiving point.
ITEM
1

Self-explanatory.

2

Name of the city to which shipment is to be made.
Show State only if different from item 3.

3

Self-explanatory.

4

Enter the title of the Distributing Agency' s representative
who is accountable for distribution of donated foods.
Names are not to be shown unless essential to the
Distributing Agency's operation. The Entity Number is
the code designation assigned by USDA for a
destination receiving point and will be filled in by the
Distribution Agency each time the form is submitted.
(Prior to submitting the form for establishment of a new
destination receiving point, the Distributing Agency will
contact the FNS Regional Office and obtain an Entity
Number.)

5

6

If delivery at destination is to be accepted by the
Distributing Agency' s representative (shown in item
4), enter "Same as item 4." If delivery at destination
is to be accepted by someone other than the
representative shown in item 4, that person's title is
inserted here. Names are not being shown unless
essential to the Distributing Agency's operatIon.
This item is used jointly with item 7 since the
information to be supplied is dependent upon the
method of shipment indicated in item 7.
A. For Rail Delivery - No entry is to be made unless
delivery to a specific location is essential to program
operations; e.g., the receiving warehouse is located
on a rail siding. When an entry is necessary, the
address shown shall include the specific location at
which the car is to be placed for unloading. When
reciprocal switching is not in

Limitations. Show limiting conditions, if any, at the
destination point; e.g., "Cannot handle care over maximum
length of 53 feet."
B. For Truck Delivery. Show exact street address for
location at which delivery will be accepted. If same as for
"Rail Delivery," enter "Same as for rail delivery."
7

8

It is desirable that shippers be allowed to make shipment
by either rail or truck so that the means of transportation
can be selected which will result in least transportation
costs. Distributing agencies may restrict the method of
shipment only when necessary to their program operations.
If a specific mode of transportation is shown, an
explanation must be made of the need for the restriction.
If this person is the same as the one to whom the
Notice of Shipment is sent , enter " Same as item 9. "
Names are not to be shown unless essential to the
Distributing Agency' s operations.

9

Self-explanatory. Names are not to be shown unless
essential to the Distributing Agency' s operations.

10

Indicate the outlet(s) to which distributions are made
from this destination point .

11

12, 13, and 14 self-explanatory.

15 & The Distributing Agency' s representative (item 4) will
16
complete these entries.