Information Collection

School Food Authority (NSLP/SBP/SMP)

IC 3005 under ICR 201604-0584-002 · OMB 0584-0284.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment A.1 School Lunch, Breakfast, Snack Claim for Reimbursement.pdf	Other-Attachment A.1 School Lunch/Br
Attachment A.2 Milk Claim for Reimbursement.pdf	Other-Attachment A.2 Milk Claim for
Attachment A.3 National School Lunch, Breakfast, and Commodity School Program Application.pdf	Other-Attachment A.3 National School
Attachment A.3 National School Lunch, Breakfast, and Commodity School Program Site Data.pdf	Other-Attachment A.3 National School
Attachment A.4 Special Milk Program Application, Agreement Policy Statement.pdf	Other-Attachment A.4 Special Milk Pr
Attachment A.4 Special Milk Program Site Data.pdf	Other-Attachment A.4 Special Milk Pr

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Attachment A.1 School Lunch/Breakfast/Snack Claim for Reimbursement	Attachment A.1 School Lunch, Breakfast, Snack Claim for Reimbursement.pdf	Yes	Yes	Fillable Fileable Signable
Other-Attachment A.2 Milk Claim for Reimbursement	Attachment A.2 Milk Claim for Reimbursement.pdf	Yes	Yes	Fillable Fileable Signable
Other-Attachment A.3 National School Lunch, Breakfast, and Commodity School Program Application	Attachment A.3 National School Lunch, Breakfast, and Commodity School Program Application.pdf	Yes	Yes	Fillable Fileable Signable
Other-Attachment A.3 National School Lunch, Breakfast and Commodity School Program Site Data	Attachment A.3 National School Lunch, Breakfast, and Commodity School Program Site Data.pdf	Yes	Yes	Fillable Fileable Signable
Other-Attachment A.4 Special Milk Program Application, Agreement Policy Statement	Attachment A.4 Special Milk Program Application, Agreement Policy Statement.pdf	Yes	Yes	Fillable Fileable Signable
Other-Attachment A.4 Special Milk Program Site Data	Attachment A.4 Special Milk Program Site Data.pdf	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: 60

Number of Respondents for Small Entity: 60

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	660	-1,860	2,520
Annual IC Time Burden (Hours)	330	-930	1,260
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.