Burden Table

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#0584-0293

FNS Food Distribution Programs Burden Hour Estimates

AFFECTED PUBLIC: STATE, LOCAL, AND TRIBAL GOVERNMENTS
Sec. of
Regs./Authority

Title

Form No.

Cash In Lieu of Donated Foods for
FNS-44
Nonresidential Child and Adult Care
Institutions
Cash In Lieu of Donated Foods for
240.5
FNS-10
Commodity Schools
Funds for SAs That Have Phased Out
240.6
FNS-10
Facilities
247.4(a)(1) & (b) Federal/State Agreements
FNS-74
247.4(a)(2) & (b) State/Local Agreements
& (c)
State Plan
247.6(a-c)
247.6(d)
State Plan Amendments
247.7(a)
Applications of Local Agencies
247.19(a)
Agreement to Prevent Dual Participation
247.23(b)
State Provision of Administrative Funds
247.26
Closeout Procedures
247.29(a) & (b) Receipt, Disposal, and Inventory of Donated FNS-153
(2)(ii)
Foods
247.29(a)& (b)(3) Civil Rights Participation Data
FNS-191
240.4

247.31(c)
247.34
250.13(a)(6)
250.13(f)
250.17(a) &
251.10(d)(2)
250.17(e)

250.58

250.69(f)

Audit Responses
Management Reviews
Destination Data for Delivery of Donated
Foods
Report of Shipment Received, Over, Short,
and/or Damaged
Commodity Inventory Report

No. of Responses Total Annual
per Respondent Responses (exf)

Est. total Hours per
Response

Est. total Burden
(gxh)

Burden Contained in OMB #0584-0078
Burden Contained in OMB #0584-0002
Burden Contained in OMB #0584-0002
Burden Contained in OMB #0584-0067
50
1.00
1
35
30
60
20
20
20

1.00
1.00
1.00
1.00
0.25
1.00
12.00

50.00

2.00

100.00

1.00
35.00
30.00
60.00
5.00
20.00
240.00

50.00
5.00
2.00
1.00
150.00
8.00
6.30

50.00
175.00
60.00
60.00
750.00
160.00
1512.00

Burden Contained In OMB # 0584-0025

FNS-7

20
35
180

4.00
2.06
7.00

80.00
72.00
1,260.00

40.00
8.00
0.50

3200.00
575.96
630.00

FNS-57

330

303.00

99,991.32

0.02

1999.83

FNS-155

30

2.00

60.00

0.67

40.20

15
2

4.00
3.00

60.00
6.00

24.00
2.00

1440.00
12.00

70,620.00
4,350.00

0.10
0.10

7062.00
435.00

Other Reporting
Recall Response Reporting
State Option Contract Program
Ordering Donated Food
Direct Delivery of Commodities
FNS-52
Multi-Commodity Food Requisition
FNS-53
State Report of Commodities Distributed for FNS-292
Disaster Relief

State, Local Tribal Governments

Est. No. of
Respondents

110
642.00
145
30.00
Burden Contained in OMB #0584-0067

1

#0584-0293
253.5(a) &
254.3(a)
253.3(c)
253.8(b) &
254.3(a)
253.8(f) &
254.3(a)
253.5(i) &
254.3(a)
ARRA FDPIR

Plans of Operation

24

1.01

24.26

3.00

72.79

FNS-152

23
97

1.00
12.00

23.00
1,164.00

1.00
2.50

23.00
2910.00

Damaged, or Out of Condition Commodities FNS-57

97

1.55

150.35

0.25

37.59

Monitoring and Review of Program
Operations
ARRA Related Financial Status Reports

97

1.00

97.00

2.00

194.00

97

6.00

582

0.75

436.50

330

542.37

178,980.93

0.12

21935.87

Prime Vendor Pilot
Commodity Inventories

SF-425

TOTAL REPORTING

Sec. of Regs.
240.4
240.5
240.6
247.22
247.28(b)
247.29(a)
247.30(d)(3)
253.5(h) &
254.4(a)

253.5(j) &
254.3(a)
253.7(h) &
254.3(a)
253.11(b) &
254.3(a)

Title

Form No.

Est. No. of
Est. # of Records
Recordkeepers per Recordkeeper

Total Annual
Records

Est. total Hours per
Record

Est. total Burden

Cash In Lieu of Donated Foods for
Nonresidential Child Care Institutions
Cash In Lieu of Donated Foods for
Commodity Schools
Funds for States That Have Phased Out
Facilities
Record of Use of Funds
Records of Receipt, Disposal & Inventory of
Donated Foods
Records of Fair Hearing Proceedings
Records of Participant Claims
Recordkeeping of Reports:
Plans of Operation
Household Applications
Reporting Changes
Disposal of Out of Condition
Commodities
ITO Applications
Commodity Inventories
Damaged or Out of Condition
Commodities
Financial Status Reports
Investigations and Complaints

56

12.00

672.00

0.25

168.00

3

12.00

36.00

0.25

9.00

56

93.64

5,243.84

0.25

1310.96

20
56

12.00
12.86

240.00
720.16

0.05
0.05

12.00
36.01

20
56

36.00
8.93

720.00
500.08

0.05
0.08

36.00
40.01

97
97
97
25

1.00
824.74
46.39
1.00

97.00
79,999.78
4,499.83
25.00

0.08
0.08
0.08
0.08

7.76
6399.98
359.99
2.00

97
97
97

1.00
12.00
1.55

97.00
1,164.00
150.00

0.08
0.08
0.08

7.76
93.12
12.00

97
97

4.00
1.00

388.00
97.00

0.08
3.00

31.04
291.00

Fair Hearings

97

1.00

97.00

0.25

24.25

Management of Administration Funds

97

1.00

97.00

0.50

48.50

56

1693.64

94,843.69

0.09

8889.37

TOTAL RECORDKEEPING
State, Local Tribal Governments

2

#0584-0293

Est. No. of
Respondents
Reporting

No. of Responses
per Respondent

330

542.37

Recordkeeping
TOTAL

State, Local Tribal Governments

330

3

542.37

Total Annual
Responses

Est. total Hours per
Response

Est. total Burden

178,980.93

0.12

21935.87

8,132.08

0.09

8889.37

187,169.01

0.16

30825.24

#0584-0293

Change in Burden

State, Local Tribal Governments

4

#0584-0293

0

Change in Burden

0

State, Local Tribal Governments

5

#0584-0293

FNS Food Distribution Programs Burden Hour Estimates

AFFECTED PUBLIC: PRIVATE - FOR PROFIT
REPORTING
Sec. of
Regs./Authority
250.17(c) and
250.30(m)
250.18(c)

Description of Collection Activity

Form No.

Est. No. of
Respondents

No. of Responses
per Respondent

Total Annual
Responses

Est. total Hours per
Response

Est. total Burden

Processors' Performance Reports

500

9

4,500

1

4,500.00

Multi-State Processor’s Response to CPA
Audit Deficiencies

30

2

60

4

240.00

TOTAL: Summary of Private For Profit Burden

500

9.120

4,560

1.039

4,740.00

Change in
Burden

0

RECORDKEEPING
Sec. of Regs.
240.4
250.18(b)
250.30(c)

Description of Collection Activity

Form No.

Est. No. of Record Est. # of Records
keepers
per Record keeper

Cash In Lieu of Donated Foods for
Nonresidential Child Care Institutions
Multi-State Processor CPA Audits
Recordkeeping Requirements for All
Processors

TOTAL RECORDKEEPING
SUMMARY OF PRIVATE FOR PROFIT

181,989

0.25

45,497.25

15
57

2
1

30
57

0.35
0.5

10.50
28.50

500

364.152

182,076

0.250

45,536.25

No. of Responses
per Respondent
9.120

Recordkeeping

Private For Profit

500

6

Est. total Burden

363.978

500

TOTAL

Est. total Hours per
Record

500

Est. No. of
Respondents
Reporting

Total Annual
Records

9.120

Total Annual
Responses

Est. total Hours per
Response

Est. total Burden

4,560

1.039

4,740.00

182,076

0.250

45,536.25

187,136

0.269

50,276.25

Change in
Burden

0

#0584-0293

FNS Food Distribution Programs Burden Hour Estimates

AFFECTED PUBLIC: PRIVATE - NOT FOR PROFIT
REPORTING
Sec. of
Regs./Authority

Title

Est. No. of
Respondents

Form No.

No. of Responses
per Respondent

250.10(b) &
250.12 (a)

USDA Agreements with Private Agencies
and Distributing Agencies

FNS-74

Burden Contained in OMB #0584-0067

250.12(a) &
250.42(c )

Distributing Agency Agreements/Agreements FNS-74
for Cash in Lieu of Commodities

Burden Contained in OMB #0584-0067

250.12(b)

Distributing Agency/Recipient Agency
Agreement
Storage Facility Agreements

250.12(e) &
250.14(d)
250.12(f) &
250.30(c)
250.13(i)

250.14(f)
250.15(a)
250.15(f)(4)
250.17(b) &
250.30(o)
250.19(b)
250.22
250.30(k)

250.30(l)
250.30(m)
250.30(s)
250.53

Est. total Hours per
Response

Est. total Burden

11,211

0.25

2,802.75

0.2

560.55

250

0.25

62.50

0.33

20.63

30

5.4

162.00

2

324.00

57

1

57.00

0.33

18.81

252

1

252.00

50

12,600.00

6
6

1
1

6.00
6.00

30
10

180.00
60.00

Distributing Agency's Physical Inventory
Reporting
Recipient Agency Excessive Inventories
Distribution Charges
Excess Funds Justification
Processing Inventory Reports

97

1

97.00

2

194.00

20
97
5
57

1
0.33
1
4

20.00
32.01
5.00
228

0.33
0.25
0.33
4

6.60
8.00
1.65
912

Distributing Agency's Management
Evaluation System
Reporting Irregularities Found Through
Complaints
Processing Refund Applications
Processing Contract Preparation Approval
and Submission to FNS
Processor's Monthly Performance Reports FNS-519A
and Processor's Inventory Reports
519B
Processing Manual
Contract Provisions Between RAs and Food
Service Management Companies

97

1

97.00

0.33

32.01

78

8

624.00

0.1

62.40

2,350
19

3
12

7,050.00
228.00

0.57
2

4,018.50
456.00

40

13

520

3

1,560

57
2,783

1
1

57
2,783.00

0.33
1

18.81
2,783.00

Processor/Processing Agreements with
Distributing Agencies/Recipient Agencies
Notification of Suspected Embezzlement,
Misuse, Theft, etc.
Commodity Acceptability Reports

250.13(k) &
250.17(d)
250.14(a)(2)
Noncommercial Warehouse Evaluation
250.14(a) (4)(iv) Cost Comparison of Existing Warehouse
System with Commercial System
250.14(e)

Total Annual
Responses

Private Not For Profit

FNS-663

&

7

Change in Burden

#0584-0293
250.69(a) &
250.70(a)
250.69(g)

Emergency Organization Feeding
Application to State for Disasters and
Situations of Distress
State Written Request for Replacement of
Donated Disaster Foods

251.2(c) &
251.5(a)

Federal-State Agreements and State Agency FNS-74
Recipient Agency Agreements

251.4(g)
251.4(j)
251.4(l)

Availability and Control of Commodities
Inter Agency Agreements
Commodity Losses and Claims
Determinations
State Agency Distribution Plan
Report of State Administrative Cost Matching FNS-667
Requirements
Report of State Administrative Cost Matching FNS-667
Requirements
Monitoring Eligible Recipient Agencies

251.6(b)
251.9(e) &
251.10(d) (1)
ARRA TEFAP
251.10(e)

TOTAL REPORTING

500

1

500.00

0.02

10.00

10

1

10.00

1

10.00

Burden Contained in OMB #0584-0067
56
2
100

1
1
1

56.00
2.00
100.00

2
0.5
8

112.00
1.00
800.00

14
55

1
5

14.00
275.00

19
3.5

266.00
962.50

55

8

440.00

3.5

1,540.00

56

1

56.00

2

112.00

11,211

1.476

16,542.26

1.670

27,630.46

0

Est. total Burden

Change in Burden

RECORDKEEPING
Sec. of Regs.

Title

250.10(b) &
250.12(a)

USDA Agreements with Private
Agencies/Distributing Agencies

250.12(b)

Distributing Agency Agreements with
Recipient Agencies
Storage Facility Agreement

250.12(e) &
250.14(d)
250.12(f) &
250.30(c)(1)
250.13(a)(1)(v)

Processing Contracts

Distributing Agency Documentation for the
Transfer of Donated Foods
Distributing Agency Documentation of
250.13(a)(5)
Method Used to Determine Commodity
Value
250.14(c)
Storage Facility Reviews
250.14(e)
Physical Inventory Records
250.15(f)
Segregating Operating Funds
250.16 & 250.30 Maintenance of Records (Including
Processor Contracts)
Maintain Management Evaluation & Review
250.19(b)
Records
250.22
Distributing Agency Complaint Records
250.53 & 250.54 RA Recordkeeping and Reviews of Food
Service Management Companies
250.64(f)
Records and Reports in the Pacific Islands

Private Not For Profit

Form No.
FNS-74

Est. No. of
Recordkeepers

Est. # of Records
per Recordkeeper

Total Annual
Records

Est. total Hours per
Record

Burden Contained in OMB #0584-0067

11,211

1

11,211.00

0.08

896.88

250

1

250.00

0.08

20.00

30

5.533

166.00

0.08

13.28

97

1

97.00

0.08

7.76

68

1

68.00

0.08

5.44

97
97
11,211
11,211

1
1
9.365801445
10.257782535

97.00
97.00
105,000.00
115,000.00

0.08
0.08
0.08
0.08

7.76
7.76
8,400.00
9,200.00

88

1

88.00

0.33

29.04

97
2,783

1
1

97.00
2,783.00

0.33
0.25

32.01
695.75

88

1

88.00

2

176.00

8

#0584-0293
250.67(a) (2)(ii)
250.69(a) &
250.70(a)
251.2(c )(1)
251.2(c)(2) &
251.5(a)
251.4(g)
251.4(j)
251.4(l)(5)
251.10(a)(1)
251.10(a) (2)
251.10(a)(3)

Correctional Institutions
Records for Disaster Organizations Maintain
Applications
Federal-State Agreements
State Agency-Eligible Recipient Agency
Agreements
Documentation of Transfer of Section 32
Commodities
Inter-Agency Agreements
Claims and Adjustments
Receipt, Disposal, and Inventory of
Commodities
Funds Paid to Eligible Recipient Agencies
for Storage and Distribution
Eligibility Determination and Collection of
Participating Household Information

300
1,000

1
1

300.00
1,000.00

0.08
0.02

24.00
20.00

56
1,600

1
1

56.00
1,600.00

0.08
0.08

4.48
128.00

56

1

56.00

0.33

18.48

2
56
56

1
1
1

2.00
56.00
56.00

0.08
2
5.67

0.16
112.00
317.52

56

1

56.00

0.33

18.48

1,600

1

1,600.00

419.9

671,840.00

TOTAL RECORDKEEPING

11,211

21.392

239,824.00

2.885

691,974.80

Est. No. of
Respondents
Reporting

No. of Responses
per Respondent

11,211

1.476

Recordkeeping
TOTAL

Private Not For Profit

11,211

9

1.476

Total Annual
Responses

Est. total Hours per
Response

Est. total Burden

16,542.26

1.670

27,630.46

239,824.00

2.885

691,974.80

267,577.26

2.689

719,605.26

0

#0584-0293

FNS Food Distribution Programs Burden Hour Estimates

AFFECTED PUBLIC: INDIVIDUAL OR HOUSEHOLD
REPORTING
Sec. of
Regs./Authority

Respondent
Type

Title

Form No.

Est. No. of
Respondents

247.8 &
Elderly
Applications/Recertifications
247.16(a)
247.8 &
Women, infants Applications/Recertifications
247.16(a)
and children
253.7 & 254.3(a) Certification of
Household to
Participate

457,000

TOTAL

Individual/Households

10

No. of
Responses per
Respondent

Total Annual
Responses

Est. total Hours
per Response

in
Est. total Burden Change
Burden

2.000

914,000

0.25

228,500

47,586

2.000

95,172

0.5

47,586

4,667

1.00

4,667

0.51

2380.17

0.051

457,000

2.218

1,013,839

0.275

278,466

0.051

OMB# 0584-0293 Annualized Cost to Respondent

Type of Respondent
State, Local, and Tribal
Governments
Private For Profit
Private Not for Profit
Individual
Total Cost

Number of
Respondents

Frequency of
Responses

Hourly Wage
Rate

Average Time
per Response

330.00
500.00
11,211.00
457,000.00
469,041.00

542.37
9.12
1.48
2.22

$13.12
$13.12
$13.12
$13.12
$13.12

0.12
1.04
1.67
0.27

Respondent Cost
$287,798.56
$62,188.80
$362,511.60
$3,653,476.15
$4,365,975.11

#0584-0293

FNS Food Distribution Programs Burden Hour Estimates
Reporting
Affected Public

Est. No. of
Respondents

No. of Responses
per Respondent

Total Annual
Responses

Est. total Hours per
Response

Est. total Burden

State, Local, and Tribal
Governments

330.00

542.37

178,980.93

0.12

21,935.87

Private For Profit

500.00

9.12

4,560.00

1.04

4,740.00

Private Not for Profit

11,211.00

1.48

16,542.26

1.67

27,630.46

Individual

457,000.00

2.22

1,013,839.00

0.27

278,466.17

Total Burden Estimates

469,041.00

2.59

1,213,922.19

0.27

332,772.49

Record Keeping
Affected Public
State, Local, and Tribal
Governments
Private For Profit
Private Not for Profit

Individual
Total Burden Estimates

Est. No. of
Respondents

No. of Responses
per Respondent

Total Annual
Responses

Est. total Burden

0.00

0.00

8,188.05

0.16

8,889.37

0.00
0.00
0.00
11,211.00

0.00
0.00
0.00
39.41

182,576.00
251,035.00
0.00
441,799.05

0.27
2.89
0.00

45,536.25
691,974.80
0.00
746,400.42

Est. No. of
Respondents
Reporting
Recordkeeping
TOTAL

BURDEN SUMMARY

Est. total Hours per
Response

469,041.00
0.00

No. of Responses
per Respondent
2.59
0.00
2.59

Total Annual Responses
1,213,922.19
441,799.05
1,655,721.24

Est. total
Hours per
Response
0.27
0.00
0.27

Est. total Burden
332,772.49
746,400.42
1,079,172.92