Attachment 2 - FDPIR income deductions 080613

Attachment 2 - FDPIR income deductions 080613.xlsx

Food Distribution Programs (0584-AE05)

Attachment 2 - FDPIR income deductions 080613

OMB: 0584-0293

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0584-0293 can be found here:

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Overview

State, Local, Tribal
Private For Profit
Private NOT For Profit
Individuals
Annualized Cost to Respondent
Burden Summary

Sheet 1: State, Local, Tribal

	FNS Food Distribution Programs Burden Hour Estimates


			AFFECTED PUBLIC: STATE, LOCAL, AND TRIBAL GOVERNMENTS

Sec. of Regs./Authority	Title	Form No.	Est. No. of Respondents	No. of Responses per Respondent	Total Annual Responses (exf)	Est. total Hours per Response	Est. total Burden (gxh)	Currently Approved Burden	Change in Burden
240.4	Cash In Lieu of Donated Foods for Nonresidential Child and Adult Care Institutions	FNS-44	Burden Contained in OMB #0584-0078
240.5	Cash In Lieu of Donated Foods for Commodity Schools	FNS-10	Burden Contained in OMB #0584-0002
240.6	Funds for SAs That Have Phased Out Facilities	FNS-10	Burden Contained in OMB #0584-0002
247.4(a)(1) & (b)	Federal/State Agreements	FNS-74	Burden Contained in OMB #0584-0067
247.4(a)(2) & (b) & (c)	State/Local Agreements		50	1.00	50.00	2.00	100.00	100.00	0.00
247.6(a-c)	State Plan		1	1.00	1.00	50.00	50.00	50.00	0.00
247.6(d)	State Plan Amendments		35	1.00	35.00	5.00	175.00	175.00	0.00
247.7(a)	Applications of Local Agencies		30	1.00	30.00	2.00	60.00	60.00	0.00
247.19(a)	Agreement to Prevent Dual Participation		60	1.00	60.00	1.00	60.00	60.00	0.00
247.23(b)	State Provision of Administrative Funds		20	0.25	5.00	150.00	750.00	750.00	0.00
247.26	Closeout Procedures		20	1.00	20.00	8.00	160.00	160.00	0.00
247.29(a) & (b)(2)(ii)	Receipt, Disposal, and Inventory of Donated Foods	FNS-153	20	12.00	240.00	6.30	1512.00	1512.00	0.00
247.29(a)& (b)(3)	Civil Rights Participation Data	FNS-191	Burden Contained In OMB # 0584-0025						0.00
247.31(c)	Audit Responses		20	4.00	80.00	40.00	3200.00	3200.00	0.00
247.34	Management Reviews		35	2.06	72.00	8.00	575.96	575.96	0.00
250.13(a)(6)	Destination Data for Delivery of Donated Foods	FNS-7	180	7.00	1,260.00	0.50	630.00	630.00	0.00
250.13(f)	Report of Shipment Received, Over, Short, and/or Damaged	FNS-57	330	303.00	99,991.32	0.02	1999.83	1999.83	0.00
250.17(a) & 251.10(d)(2)	Commodity Inventory Report	FNS-155	30	2.00	60.00	0.67	40.20	40.20	0.00
250.17(e)	Other Reporting								0.00
	Recall Response Reporting		15	4.00	60.00	24.00	1440.00	1440.00	0.00
	State Option Contract Program		2	3.00	6.00	2.00	12.00	12.00	0.00
250.58	Ordering Donated Food								0.00
	Direct Delivery of Commodities	FNS-52	110	642.00	70,620.00	0.10	7062.00	7062.00	0.00
	Multi-Commodity Food Requisition	FNS-53	145	30.00	4,350.00	0.10	435.00	435.00	0.00
250.69(f)	State Report of Commodities Distributed for Disaster Relief	FNS-292	Burden Contained in OMB #0584-0067						0.00
253.5(a) & 254.3(a)	Plans of Operation		24	1.01	24.26	3.00	72.79	72.79	0.00
253.3(c)	Prime Vendor Pilot		23	1.00	23.00	1.00	23.00	23.00	0.00
253.8(b) & 254.3(a)	Commodity Inventories	FNS-152	97	12.00	1,164.00	2.50	2910.00	2910.00	0.00
253.8(f) & 254.3(a)	Damaged, or Out of Condition Commodities	FNS-57	97	1.55	150.35	0.25	37.59	37.59	0.00
253.5(i) & 254.3(a)	Monitoring and Review of Program Operations		97	1.00	97.00	2.00	194.00	194.00	0.00
ARRA FDPIR	ARRA Related Financial Status Reports	SF-425	97	6.00	582	0.75	436.50	436.50	0.00
	TOTAL REPORTING		330	542.37	178,980.93	0.12	21935.87	21935.87	0

Sec. of Regs.	Title	Form No.	Est. No. of Recordkeepers	Est. # of Records per Recordkeeper	Total Annual Records	Est. total Hours per Record	Est. total Burden	Currently Approved Burden	Change in Burden
240.4	Cash In Lieu of Donated Foods for Nonresidential Child Care Institutions		56	12.00	672.00	0.25	168.00	168.00	0.00
240.5	Cash In Lieu of Donated Foods for Commodity Schools		3	12.00	36.00	0.25	9.00	9.00	0.00
240.6	Funds for States That Have Phased Out Facilities		56	93.64	5,243.84	0.25	1310.96	1310.96	0.00
247.22	Record of Use of Funds		20	12.00	240.00	0.05	12.00	12.00	0.00
247.28(b)	Records of Receipt, Disposal & Inventory of Donated Foods		56	12.86	720.16	0.05	36.01	36.01	0.00
247.29(a)	Records of Fair Hearing Proceedings		20	36.00	720.00	0.05	36.00	36.00	0.00
247.30(d)(3)	Records of Participant Claims		56	8.93	500.08	0.08	40.01	40.01	0.00
253.5(h) & 254.4(a)	Recordkeeping of Reports:								0.00
	Plans of Operation		97	1.00	97.00	0.08	7.76	7.76	0.00
	Household Applications		97	824.74	79,999.78	0.08	6399.98	6399.98	0.00
	Reporting Changes		97	50.00	4,850.00	0.08	388.00	359.99	28.01
	Disposal of Out of Condition Commodities		25	1.00	25.00	0.08	2.00	2.00	0.00
	ITO Applications		97	1.00	97.00	0.08	7.76	7.76	0.00
	Commodity Inventories		97	12.00	1,164.00	0.08	93.12	93.12	0.00
	Damaged or Out of Condition Commodities		97	1.55	150.00	0.08	12.00	12.00	0.00
	Financial Status Reports		97	4.00	388.00	0.08	31.04	31.04	0.00
253.5(j) & 254.3(a)	Investigations and Complaints		97	1.00	97.00	3.00	291.00	291.00	0.00
253.7(h) & 254.3(a)	Fair Hearings		97	1.00	97.00	0.25	24.25	24.25	0.00
253.11(b) & 254.3(a)	Management of Administration Funds		97	1.00	97.00	0.50	48.50	48.50	0.00
	TOTAL RECORDKEEPING		97	981.38	95,193.86	0.09	8917.39	8889.3732000	28.0136


			Est. No. of Respondents	No. of Responses per Respondent	Total Annual Responses	Est. total Hours per Response	Est. total Burden	Currently Approved Burden	Difference
		Reporting	330	542.37	178,980.93	0.12	21935.8659	21935.87	0.00
		Recordkeeping	97	84.41	8,188.05	1.09	8917.3868	8889.37	28.01
		TOTAL	330	567.178724	187,168.98	0.16	30853.25	30825.24	28.01

Sheet 2: Private For Profit

		FNS Food Distribution Programs Burden Hour Estimates


				AFFECTED PUBLIC: PRIVATE - FOR PROFIT
REPORTING
	Sec. of Regs./Authority	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	Change in Burden
	250.17(c) and 250.30(m)	Processors' Performance Reports		500	9	4,500	1	4,500.00
	250.18(c)	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	0

RECORDKEEPING
	Sec. of Regs.	Description of Collection Activity	Form No.	Est. No. of Record keepers	Est. # of Records per Record keeper	Total Annual Records	Est. total Hours per Record	Est. total Burden	Change in Burden
	240.4	Cash In Lieu of Donated Foods for Nonresidential Child Care Institutions		500	363.978	181,989	0.25	45,497.25
	250.18(b)	Multi-State Processor CPA Audits		15	2	30	0.35	10.50
	250.30(c)	Recordkeeping Requirements for All Processors		57	1	57	0.5	28.50
		TOTAL RECORDKEEPING		500	364.152	182,076	0.250	45,536.25	0

SUMMARY OF PRIVATE FOR PROFIT
				Est. No. of Respondents	No. of Responses per Respondent	Total Annual Responses	Est. total Hours per Response	Est. total Burden
			Reporting	500	9.120	4,560	1.039	4,740.00
			Recordkeeping	500	364.152	182,076	0.250	45,536.25
			TOTAL	500	373.272	186,636	0.269	50,276.25

Sheet 3: Private NOT For Profit

	FNS Food Distribution Programs Burden Hour Estimates


			AFFECTED PUBLIC: PRIVATE - NOT FOR PROFIT
	REPORTING
Sec. of Regs./Authority	Title	Form No.	Est. No. of Respondents	No. of Responses per Respondent	Total Annual Responses	Est. total Hours per Response	Est. total Burden	Change in Burden
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 for Cash in Lieu of Commodities	FNS-74	Burden Contained in OMB #0584-0067
250.12(b)	Distributing Agency/Recipient Agency Agreement		11,211	0.25	2,802.75	0.2	560.55
250.12(e) & 250.14(d)	Storage Facility Agreements		250	0.25	62.50	0.33	20.63
250.12(f) & 250.30(c)	Processor/Processing Agreements with Distributing Agencies/Recipient Agencies		30	5.4	162.00	2	324.00
250.13(i)	Notification of Suspected Embezzlement, Misuse, Theft, etc.		57	1	57.00	0.33	18.81
250.13(k) & 250.17(d)	Commodity Acceptability Reports	FNS-663	252	1	252.00	50	12,600.00
250.14(a)(2)	Noncommercial Warehouse Evaluation		6	1	6.00	30	180.00
250.14(a) (4)(iv)	Cost Comparison of Existing Warehouse System with Commercial System		6	1	6.00	10	60.00
250.14(e)	Distributing Agency's Physical Inventory Reporting		97	1	97.00	2	194.00
250.14(f)	Recipient Agency Excessive Inventories		20	1	20.00	0.33	6.60
250.15(a)	Distribution Charges		97	0.33	32.01	0.25	8.00
250.15(f)(4)	Excess Funds Justification		5	1	5.00	0.33	1.65
250.17(b) & 250.30(o)	Processing Inventory Reports		57	4	228	4	912
250.19(b)	Distributing Agency's Management Evaluation System		97	1	97.00	0.33	32.01
250.22	Reporting Irregularities Found Through Complaints		78	8	624.00	0.1	62.40
250.30(k)	Processing Refund Applications		2,350	3	7,050.00	0.57	4,018.50
250.30(l)	Processing Contract Preparation Approval and Submission to FNS		19	12	228.00	2	456.00
250.30(m)	Processor's Monthly Performance Reports and Processor's Inventory Reports	FNS-519A & 519B	40	13	520	3	1,560
250.30(s)	Processing Manual		57	1	57	0.33	18.81
250.53	Contract Provisions Between RAs and Food Service Management Companies		2,783	1	2,783.00	1	2,783.00
250.69(a) & 250.70(a)	Emergency Organization Feeding Application to State for Disasters and Situations of Distress		500	1	500.00	0.02	10.00
250.69(g)	State Written Request for Replacement of Donated Disaster Foods		10	1	10.00	1	10.00
251.2(c) & 251.5(a)	Federal-State Agreements and State Agency Recipient Agency Agreements	FNS-74	Burden Contained in OMB #0584-0067
251.2(c) & 251.5(a)		FNS-74	Burden Contained in OMB #0584-0067
251.4(g)	Availability and Control of Commodities		56	1	56.00	2	112.00
251.4(j)	Inter Agency Agreements		2	1	2.00	0.5	1.00
251.4(l)	Commodity Losses and Claims Determinations		100	1	100.00	8	800.00
251.6(b)	State Agency Distribution Plan		14	1	14.00	19	266.00
251.9(e) & 251.10(d) (1)	Report of State Administrative Cost Matching Requirements	FNS-667	55	5	275.00	3.5	962.50
ARRA TEFAP	Report of State Administrative Cost Matching Requirements	FNS-667	55	8	440.00	3.5	1,540.00
251.10(e)	Monitoring Eligible Recipient Agencies		56	1	56.00	2	112.00
	TOTAL REPORTING		11,211	1.476	16,542.26	1.670	27,630.46	0
	RECORDKEEPING
Sec. of Regs.	Title	Form No.	Est. No. of Recordkeepers	Est. # of Records per Recordkeeper	Total Annual Records	Est. total Hours per Record	Est. total Burden	Change in Burden
250.10(b) & 250.12(a)	USDA Agreements with Private Agencies/Distributing Agencies	FNS-74	Burden Contained in OMB #0584-0067
250.12(b)	Distributing Agency Agreements with Recipient Agencies		11,211	1	11,211.00	0.08	896.88
250.12(e) & 250.14(d)	Storage Facility Agreement		250	1	250.00	0.08	20.00
250.12(f) & 250.30(c)(1)	Processing Contracts		30	5.533	166.00	0.08	13.28
250.13(a)(1)(v)	Distributing Agency Documentation for the Transfer of Donated Foods		97	1	97.00	0.08	7.76
250.13(a)(5)	Distributing Agency Documentation of Method Used to Determine Commodity Value		68	1	68.00	0.08	5.44
250.14(c)	Storage Facility Reviews		97	1	97.00	0.08	7.76
250.14(e)	Physical Inventory Records		97	1	97.00	0.08	7.76
250.15(f)	Segregating Operating Funds		11,211	9.365801445	105,000.00	0.08	8,400.00
250.16 & 250.30	Maintenance of Records (Including Processor Contracts)		11,211	10.257782535	115,000.00	0.08	9,200.00
250.19(b)	Maintain Management Evaluation & Review Records		88	1	88.00	0.33	29.04
250.22	Distributing Agency Complaint Records		97	1	97.00	0.33	32.01
250.53 & 250.54	RA Recordkeeping and Reviews of Food Service Management Companies		2,783	1	2,783.00	0.25	695.75
250.64(f)	Records and Reports in the Pacific Islands		88	1	88.00	2	176.00
250.67(a) (2)(ii)	Correctional Institutions		300	1	300.00	0.08	24.00
250.69(a) & 250.70(a)	Records for Disaster Organizations Maintain Applications		1,000	1	1,000.00	0.02	20.00
251.2(c )(1)	Federal-State Agreements		56	1	56.00	0.08	4.48
251.2(c)(2) & 251.5(a)	State Agency-Eligible Recipient Agency Agreements		1,600	1	1,600.00	0.08	128.00
251.4(g)	Documentation of Transfer of Section 32 Commodities		56	1	56.00	0.33	18.48
251.4(j)	Inter-Agency Agreements		2	1	2.00	0.08	0.16
251.4(l)(5)	Claims and Adjustments		56	1	56.00	2	112.00
251.10(a)(1)	Receipt, Disposal, and Inventory of Commodities		56	1	56.00	5.67	317.52
251.10(a) (2)	Funds Paid to Eligible Recipient Agencies for Storage and Distribution		56	1	56.00	0.33	18.48
251.10(a)(3)	Eligibility Determination and Collection of Participating Household Information		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	0


			Est. No. of Respondents	No. of Responses per Respondent	Total Annual Responses	Est. total Hours per Response	Est. total Burden
		Reporting	11,211	1.476	16,542.26	1.670	27,630.46
		Recordkeeping	11,211	21.392	239,824.00	2.885	691,974.80
		TOTAL	11,211	1.476	256,366.26	2.807	719,605.26

Sheet 4: Individuals

			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	No. of Responses per Respondent	Total Annual Responses	Est. total Hours per Response	Est. total Burden	Current Approved Burden	Change in Burden
	247.8 & 247.16(a)	Elderly	Applications/Recertifications		457,000	2.000	914,000	0.25	228,500	228,500	0
	247.8 & 247.16(a)	Women, infants and children	Applications/Recertifications		47,586	2.000	95,172	0.5	47,586	47,586	0
	253.7 & 254.3(a)	Certification of Household to Participate			5,668	1.25	7,085	0.6	4251.00	2380.17	1870.83
			TOTAL		457,000	2.224	1,016,257	0.276	280,337	278,466	1870.83

Sheet 5: Annualized Cost to Respondent

Affected Public	Est. No. of Respondents	Total Annual Responses	Est. total Burden	Hourly Wage Rate	Respondent Cost
State, Local, and Tribal Governments	330.00	187,168.98	30,853.25	$13.87	$427,934.61
Private For Profit	500.00	187,136.00	50,276.25	$13.87	$697,331.59
Private Not for Profit	11,211.00	267,577.26	719,605.26	$13.87	$9,980,924.92
Individual	457,000.00	1,016,257.00	280,337.00	$13.87	$3,888,274.19
	469,041.00	1,658,139.24	1,081,071.76		$14,994,465.31

Sheet 6: Burden Summary

		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	1,016,257.00	0.28	280,337.00
Total Burden Estimates	469,041.00	2.59	1,216,340.19	0.28	334,643.32


Record Keeping
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	0.00	8,188.05	1.09	8,917.39
Private For Profit	500.00	0.00	182,576.00	0.25	45,536.25
Private Not for Profit	11,211.00	0.00	251,035.00	2.89	691,974.80
Individual	0.00	0.00	0.00	0.00	0.00
Total Burden Estimates	11,211.00	39.41	441,799.05	1.69	746,428.44



Summary	Est. No. of Respondents	No. of Responses per Respondent	Total Annual Responses	Est. total Hours per Response	Est. total Burden
Reporting	469,041.00	2.59	1,216,340.19	0.28	334,643.32
Recordkeeping	-	0.03	441,799.05	1.69	746,428.44
TOTAL	469,041.00	3.54	1,658,139.24	0.65	1,081,071.76


	Responses	Time Burden
Current OMB Inventory	1,655,721.00	1,079,173.00
Burden Revision Requested	1,658,139.24	1,081,071.76
Difference	2,418	1,899

File Type	application/vnd.openxmlformats-officedocument.spreadsheetml.sheet
File Modified	0000-00-00
File Created	0000-00-00