Information Collection

Worksheet FNS 366A and 366B OMB# 0083

IC 204662 under ICR 201409-0584-003 · 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⚠️ Notice: This information collection may be referencing outdated material.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
Form FNS 366 A Worksheet FNS 366A and 366B OMB# 0083	Form and Instruction
FNS 366a April 2014.pdf fprs.fns.usda.gov	Instruction
FNS 366b April 2014.pdf fprs.fns.usda.gov	Instruction
FNS 366 A Program and Budget Summary Statement: Budget Projection FNS-366A Screenshots.pdf fprs.fns.usda.gov	Form and Instruction
FNS 366 B Program and Budget Summary Statement: Program Activity S FNS-366B Screenshots V2.pdf fprs.fns.usda.gov	Form and Instruction

IC Title:

Worksheet FNS 366A and 366B OMB# 0083

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Mandatory

CFR Citation: 7 CFR 272.2

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 366 A	Program and Budget Summary Statement: Budget Projection	FNS-366A Screenshots.pdf	https://fprs.fns.usda.gov	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FNS 366 B	Program and Budget Summary Statement: Program Activity Statement	FNS-366B Screenshots V2.pdf	https://fprs.fns.usda.gov	Yes	Yes	Fillable Fileable Signable
Instruction			FNS 366a April 2014.pdf	https://fprs.fns.usda.gov	Yes	Yes	Fillable Fileable Signable
Instruction			FNS 366b 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: 53

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	Previously Approved
Annual Number of Responses for this IC	106	106
Annual IC Time Burden (Hours)	4,929	4,929
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.