Food Distribution Forms (State and Local Government)

Food Distribution Programs

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0293 can be found here:

Documents and Forms

Document Name Document Type
Form FNS-667 Food Distribution Forms (State and Local Government) Form
FNS-7 DESTINATION DATA FOR DELIVERY OF DESTINATION DATA FOR DE FNS-7.pdf Form
FNS-52 FOOD REQUISITION FNS-52.pdf Form
FNS-53 USDA MULTI-FOOD REQUISITION FNS-53.pdf Form
FNS-57 REPORT OF SHIPMENT RECEIVED OVER, SHORT AND/OR DAMAGED FNS-57.pdf Form
FNS-152 MONTHLY DISTRIBUTION OF DONATED FOODS TO FAMILY UNITS FNS-152.pdf Form
FNS-153 MONTHLY REPORT OF THE COMMODITY SUPPLEMENTAL FOOD PROGRA FNS-153.pdf Form
FNS-155 INVENTORY MANAGEMENT REGISTER FNS-155.pdf Form
FNS-667 REPORT OF THE EMERGENCY FOOD ASSISTANCE PROGRAM (TEFAP) FNS-667.pdf Form
SF 425 Financial Status Reports- ARRA FDPIR SF-425 for 0293 ARRA 5-19-09.pdf Form

Information Collection (IC) Details

IC Title:	Food Distribution Forms (State and Local Government)	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 240, 247, 250, 251, 253, 254 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FNS-667	REPORT OF THE EMERGENCY FOOD ASSISTANCE PROGRAM (TEFAP) ADMINISTRATIVE COSTS	FNS-667.pdf	Yes	Yes	Fillable Printable
Form	SF 425	Financial Status Reports- ARRA FDPIR	SF-425 for 0293 ARRA 5-19-09.pdf	Yes	Yes	Fillable Printable
Form	FNS-7	DESTINATION DATA FOR DELIVERY OF DESTINATION DATA FOR DELIVERY OF	FNS-7.pdf	Yes	Yes	Fillable Printable
Form	FNS-52	FOOD REQUISITION	FNS-52.pdf	Yes	Yes	Fillable Printable
Form	FNS-53	USDA MULTI-FOOD REQUISITION	FNS-53.pdf	Yes	Yes	Fillable Fileable
Form	FNS-57	REPORT OF SHIPMENT RECEIVED OVER, SHORT AND/OR DAMAGED	FNS-57.pdf	Yes	Yes	Fillable Printable
Form	FNS-152	MONTHLY DISTRIBUTION OF DONATED FOODS TO FAMILY UNITS	FNS-152.pdf	Yes	Yes	Fillable Printable
Form	FNS-153	MONTHLY REPORT OF THE COMMODITY SUPPLEMENTAL FOOD PROGRAM AND QUARTERLY ADMINISTRATIVE FINANCIAL STATUS REPORT	FNS-153.pdf	Yes	Yes	Fillable Printable
Form	FNS-155	INVENTORY MANAGEMENT REGISTER	FNS-155.pdf	Yes	Yes	Fillable Printable

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 20,866	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	738,080	266,039	284,872	187,169
Annual IC Time Burden (Hours)	96,719	20,968	44,898	30,853
Annual IC Cost Burden (Dollars)	0	0	0	0

Documents for IC

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.