Information Collection

FORMS-806-A, Claim for Reimbursement (National School Lunch and School Breakfast Programs) and FNS-806-B, Claim for Reimbursement (Special Milk Program for Children), 7 CFR Part 210, Part 220 & 215

IC 3005 under ICR 201302-0584-011 · OMB 0584-0284.

⚠️ Notice: This information collection may be referencing outdated material.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

2016-04-27 - Revision of a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FNS 806-A FORMS-806-A, Claim for Reimbursement (National School Lunch and School Breakfast Programs) and FNS-806-B, Claim for Reimbursement (Special Milk Program for Children), 7 CFR Part 210, Part 220 & 215	Form and Instruction
FNS 806-A School Lunch/Breakfast/Snack Claim for Reimbursement FNS-806A.pdf	Form and Instruction
FNS 806-B Milk Claim for Reimbursement FNS-806B.pdf	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

FORMS-806-A, Claim for Reimbursement (National School Lunch and School Breakfast Programs) and FNS-806-B, Claim for Reimbursement (Special Milk Program for Children), 7 CFR Part 210, Part 220 & 215

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:

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 806-A	School Lunch/Breakfast/Snack Claim for Reimbursement	FNS-806A.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	FNS 806-B	Milk Claim for Reimbursement	FNS-806B.pdf		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 210

Number of Respondents for Small Entity: 210

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	2,520	-276	2,796
Annual IC Time Burden (Hours)	1,260	-138	1,398
Annual IC Cost Burden (Dollars)	0	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.