Information Collection

Worksheet FNS 152, 153 & 667 OMB# 0293

IC 204625 under ICR 201207-0584-008 · OMB 0584-0594.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0594 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
FNS-152 April 2014.pdf fprs.fns.usda.gov	Instruction
FNS-153 April 2014.pdf fprs.fns.usda.gov	Instruction
FNS 667 April 2014.pdf fprs.fns.usda.gov	Instruction
FNS 152 Monthly Distribution of Donated Food to Family Units FNS-152 Screenshots V2.pdf fprs.fns.usda.gov/Home/Reminder.aspx	Form and Instruction
FNS 153 Monthly Report of the CSFP and Quarterly Administrative FNS-153 Screenshots V2.pdf fprs.fns.usda.gov/Home/Reminder.aspx	Form and Instruction
FNS 667 Report of The Emergency Food Assistance Programs (TEFAP) FNS-667 Screenshots V2.pdf fprs.fns.usda.gov/Home/Reminder.aspx	Form and Instruction

IC Title:

Worksheet FNS 152, 153 & 667 OMB# 0293

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 7 CFR 250.17 7 CFR 251.10

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
Instruction			FNS-153 April 2014.pdf	https://fprs.fns.usda.gov	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FNS 667	Report of The Emergency Food Assistance Programs (TEFAP) Administrative Costs	FNS-667 Screenshots V2.pdf	https://fprs.fns.usda.gov/Home/Reminder.aspx	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FNS 152	Monthly Distribution of Donated Food to Family Units	FNS-152 Screenshots V2.pdf	https://fprs.fns.usda.gov/Home/Reminder.aspx	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FNS 153	Monthly Report of the CSFP and Quarterly Administrative Financial Status Report	FNS-153 Screenshots V2.pdf	https://fprs.fns.usda.gov/Home/Reminder.aspx	Yes	Yes	Fillable Fileable Signable
Instruction			FNS-152 April 2014.pdf	https://fprs.fns.usda.gov	Yes	Yes	Fillable Fileable Signable
Instruction			FNS 667 April 2014.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: 111

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,111	2,111
Annual IC Time Burden (Hours)	7,468	7,468
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.