Monthly Claim for Reimbursement FNS 806-A & B

Monthly Claim for Reimbursement

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0284 can be found here:

Documents and Forms

Document Name Document Type
Form FNS 806-A Monthly Claim for Reimbursement FNS 806-A & B Form and Instruction
FNS 806-A School Lunch/Breakfast/Snack Claim for Reimbursement FNS-806 A 12-2009.pdf Form and Instruction
FNS 806-A (Electro School Lunch/Breakfast/Snack Claim for Reimbursement FNS 806-A (electronic).pdf Form and Instruction
FNS 806-B Milk Claim for Reimbursement FNS 806-B.pdf Form and Instruction
FNS 806-B Milk Claim for Reimbursement FNS 806-B (electronic).pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Monthly Claim for Reimbursement FNS 806-A & B	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FNS 806-A	School Lunch/Breakfast/Snack Claim for Reimbursement	FNS-806 A 12-2009.pdf	No		Printable Only
Form and Instruction	FNS 806-A (Electronic)	School Lunch/Breakfast/Snack Claim for Reimbursement	FNS 806-A (electronic).pdf	Yes	Yes	Fillable Printable
Form and Instruction	FNS 806-B	Milk Claim for Reimbursement	FNS 806-B.pdf	No		Printable Only
Form and Instruction	FNS 806-B	Milk Claim for Reimbursement	FNS 806-B (electronic).pdf	Yes	Yes	Fillable Printable

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 233	Number of Respondents for Small Entity: 233

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	2,796	66	2,730
Annual IC Time Burden (Hours)	1,398	-498	1,896
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.