Information Collection

Civil Rights Title VI - Collection Reports - FNS-191 and FNS-101

IC 2909 under ICR 201201-0584-014 · OMB 0584-0025.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FNS 101 Screenshot Civil Rights Title VI - Collection Reports - FNS-191 and FNS-101	Form and Instruction
FNS-191 Racial/Ethic Group Participation Commodity Supplemental FNS-191.pdf fprs.fns.usda.gov/	Form and Instruction
FNS-101 Participation in Food Programs - By Race FNS-101.pdf fprs.fns.usda.gov	Form and Instruction
FNS 101 Screenshot Participation in Food Program By Race E-form Fns-101_page1_part1.jpg fprs.fns.usda.gov/	Form and Instruction
FNS-101_page1_part Participation in Food Program By Race E-form Fns-101_page1_part2.jpg fprs.fns.usda.gov/	Form and Instruction
FNS-101_page2 Scre Participation in Food Program By Race E-form Fns-101_page2.jpg fprs.fns.usda.gov/	Form and Instruction
FNS 191 RACIAL/ETHNIC GROUP PARTICIPATION COMMODITY SUPPLEMENTAL FNS 191CSFP Race-Ethnic Group Participation.docx fprs.fns.usda.gov/	Form and Instruction
FNSHandbook501-Chapter1_2010.pdf FNS Handbook 501	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 7 CFR 247.37 7 CFR 272.6 28 CFR 42 Subpart C - Section 42.106 7 CFR 15.1-15.6 7 CFR 247.5 7 CFR 247.29 7 CFR 272.6

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FNS 101 Screenshot	Participation in Food Program By Race E-form	Fns-101_page1_part1.jpg	https://fprs.fns.usda.gov/	Yes	Yes	Fillable Fileable
Form and Instruction	FNS-101_page1_part2 Screenshot	Participation in Food Program By Race E-form	Fns-101_page1_part2.jpg	https://fprs.fns.usda.gov/	Yes	Yes	Fillable Fileable
Form and Instruction	FNS-101_page2 Screenshot	Participation in Food Program By Race E-form	Fns-101_page2.jpg	https://fprs.fns.usda.gov/	Yes	Yes	Fillable Fileable
Form and Instruction	FNS 191	RACIAL/ETHNIC GROUP PARTICIPATION COMMODITY SUPPLEMENTAL FOOD PROGRAM Screenshot	FNS 191CSFP Race-Ethnic Group Participation.docx	https://fprs.fns.usda.gov/	Yes	Yes	Fillable Fileable
Form and Instruction	FNS-191	Racial/Ethic Group Participation Commodity Supplemental Food Program	FNS-191.pdf	https://fprs.fns.usda.gov/	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FNS-101	Participation in Food Programs - By Race	FNS-101.pdf	https://fprs.fns.usda.gov	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,927

Number of Respondents for Small Entity: 292

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	2,927	64	2,863
Annual IC Time Burden (Hours)	5,854	128	5,726
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
FNS Handbook 501	FNSHandbook501-Chapter1_2010.pdf	05/16/2012

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