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Revised Excel Spreadsheet
ICR 201609-0584-003 · OMB 0584-0594 · Object 68108701.
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Document Metadata
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
|---|---|
| File Title | Revised Excel Spreadsheet |
| Author | cmountjoy |
| Last Modified By | Calc |
| File Modified | 2014-03-24 |
| File Created | 2026-09-12 |
| Conversion State | complete |
Extracted Text
Food and Nutrition Service Data Collection Information (by Program) Annual Burden Hours Worksheet Number Estimated No. Frequency of Total Annual Estimated Hrs Annual of Response per Response per Response Burden Hrs 1 2 Respondents Respondent Title of Worksheet Tri bal Ag en cie s Affected Current OMB Public Control Number Child Nutrition Program 0584-0002 FNS-10 Report of School Program Operations 56.0 33.8 1,891.0 2.3 4,255.0 0584-0075 FNS-13 Annual Report of State Revenue Matching 57.0 1.0 57.0 8.0 456.0 0584-0280 FNS-418 Summer Food Service Program for Children 53.0 3.0 159.0 2.0 318.0 0584-0055 FNS-44 Report of Child and Adult Care Food Program 56.0 24.0 1,344.0 1.0 1,344.0 0584-0067 NSLP, SBP, SMP, CACFP and Food Distribution FNS-777(SAE) Program (FDP) 87.0 4.0 348.0 0.5 174.0 0348-0061 SF-425 NSLP 57.0 4.0 228.0 1.5 342.0 0348-0061 SF-425 SBP 57.0 4.0 228.0 1.5 342.0 0348-0061 SF-425 SMP 57.0 4.0 228.0 1.5 342.0 0348-0061 SF-425 CACFP 55.0 4.0 220.0 1.5 330.0 0348-0061 0348-0061 SF-425 SF-425 SFSP CN Team Nutrition 53.0 57.0 4.0 4.0 212.0 228.0 1.5 1.5 318.0 342.0 0348-0061 SF-425 CN - Administrative Review & Training (I) 57.0 2.0 114.0 1.5 171.0 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 SF-425 SF-425 SF-425 SF-425 SF-425 4.0 4.0 4.0 4.0 4.0 228.0 228.0 228.0 228.0 228.0 1.5 1.5 1.5 1.5 1.5 342.0 342.0 342.0 342.0 342.0 0348-0061 SF-425 4.0 228.0 1.5 342.0 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 SF-425 SF-425 SF-425 SF-425 SF-425 SF-425 4.0 4.0 4.0 4.0 4.0 4.0 4.0 4.0 4.0 4.0 600.0 600.0 7,841.0 1.5 1.5 1.5 1.5 1.5 1.5 6.0 6.0 6.0 6.0 900.0 900.0 12,610.0 0584-0025 FNS-101 CN - Administrative Review & Training (II) 57.0 CN - Summer Food Service Program Pilot Programs 57.0 CN - Direct Certification & Verfication 57.0 CN - CACFP Child Care Wellness Grants 57.0 CN Direct Certification and Improvement 57.0 CN National School Lunch Program Equipment Grants 57.0 CN National Food Service Management Institute 1.0 (FSMI) CN FSMI Produce Safety University Support 1.0 CN FSMI Food Safety 1.0 CN FSMI General Education 1.0 CN Community Gardens Pilot Program 150.0 CN Hunger-Free Community Grants 150.0 PROGRAM SUBTOTALS 207.0 Special Nutrition Assistance Program Participation in Food Programs-By Race 2,719.0 1.0 2,719.0 2.0 5,438.0 Affected Worksheet Current OMB Public Number Control Number 0584-0069 FNS-209 Title of Worksheet Estimated No. Frequency of Total Annual Estimated Hrs Annual of Response per Response per Response Burden Hrs 1 2 Respondents Respondent Status of Claims Against Households 53.0 Program and Budget Summary Statement: Budget Projection 53.0 Program and Budget Summary Statement: 53.0 Program Activity Statement & Updates State Issuance and Participation Estimates 53.0 Project Area Issuance and Participation 53.0 Supplemental Nutrition Assistance Program 52.0 Education (SNAP-Ed) EARS Reporting Form SNAP 53.0 SNAP 7.0 SNAP Employment and Training Program Activity 53.0 Report Issuance Reconciliation Report 54.0 Disaster Relief 55.0 SNAP Outreach 53.0 SNAP Health and Census Pilot 53.0 SNAP Participation 53.0 SNAP Increasing Participation Among Elderly 53.0 SNAP Healthy Incentives 53.0 PROGRAM SUBTOTALS 2,774.0 Food Distribution Program 4.0 212.0 3.0 636.0 1.0 53.0 13.0 689.0 1.0 11.3 2.3 53.0 600.0 120.0 24.5 5.7 14.8 1,299.3 3,390.0 1,779.6 1.0 4.0 4.0 52.0 212.0 28.0 54.0 16.8 1.0 2,808.0 3,561.6 28.0 13.2 12.0 2.0 4.0 4.0 4.0 4.0 4.0 698.0 648.0 110.0 212.0 212.0 212.0 212.0 212.0 6,565.0 31.3 4.0 0.4175 1.5 1.5 1.5 1.5 1.5 21,858.6 2,592.0 45.9 318.0 318.0 318.0 318.0 318.0 45,716.0 0584-0083 FNS-366A 0584-0083 0584-0081 0584-0081 FNS-366B FNS-388 FNS-388A 0584-0542 0584-NEW 0584-NEW FNS-759 FNS-778 FNS-778a 0584-0339 0584-0080 0584-0037 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 FNS-583 FNS-46 FNS-292A&B SF-425 SF-425 SF-425 SF-425 SF-425 0584-0293 FNS-667 Report of The Emergency Food Assistance Programs (TEFAP) Administrative Costs 55.0 5.0 275.0 3.5 962.5 0584-0293 FNS-152 Monthly Distribution of Donated Food to Family Units 97.0 12.0 1,164.0 2.5 2,910.0 0584-0293 FNS-153 Monthly Report of the CSFP and Quarterly Administrative Financial Status Report 20.0 12.0 240.0 6.3 1,512.0 0348-0061 SF-425 CSFP 42.0 1.0 42.0 1.5 63.0 0584-0025 FNS-191 CSFP Racial/Ethnic Group Participation 192.0 1.0 192.0 2.0 384.0 0584-0025 FNS-101 Participation in Food Programs-By Race 111.0 1.0 111.0 2.4 268 0348-0061 SF-425 FDPNE 111.0 4.0 444.0 1.5 666.0 0348-0061 SF-425 FDPIR-NET 111.0 1.0 111.0 1.5 166.5 0348-0061 SF-425 FDPIR 111.0 4.0 444.0 1.5 666.0 Affected Current OMB Public Control Number Worksheet Number Title of Worksheet Estimated No. Frequency of Total Annual Estimated Hrs Annual of Response per Response per Response Burden Hrs 1 2 Respondents Respondent 0348-0061 SF-425 0584-0447 0584-0447 FNS-683 FNS-203 TEFAP - Infrastructure 150.0 4.0 600.0 PROGRAM SUBTOTALS 192.0 3,623.0 Special Supplemental Food Program for Women, Infants and Children (WIC) WIC Farmers' Market Nutrition Program (FMNP) 45.0 1.0 45.0 Annual Financial Report WIC Farmers' Market Nutrition Program Report 45.0 1.0 45.0 0584-0541 0584-0431 FNS-683A FNS-648 Senior Farmers' Market Nutrition Program (SFMNP) Annual Financial and Program Data Report WIC Local Agency Directory 0584-0045 FNS-798 0584-0045 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 FNS-798A SF-425 SF-425 SF-425 SF-425 SF-425 SF-425 SF-425 SF-425 SF-425 SF-425 SF-425 SF-425 SF-425 0348-0061 SF-425 51.0 90 WIC Financial Management and Participation 90.0 Report Addendum to WIC Financial Management and 90.0 Participation Report - NSA Expenditures WIC Breastfeeding Peer Counseling 90.0 WIC General Infrastructure 90.0 WIC General Infrastructure State Agency Model 90.0 WIC State Agency Model 90.0 WIC State to State Technical Assistance 90.0 WIC Technology State Agency Model 90.0 WIC Special Project Full Grant 90.0 WIC Special Project Concept Grant 90.0 WIC Breastfeeding Performance Bonus 90.0 WIC Electronic Benefits Transfer 90.0 ARRA WIC Electronic Benefits Transfer 90.0 ARRA WIC State Agency Model 90.0 ARRA WIC Technology State Agency Model 90.0 PROGRAM SUBTOTALS 90.0 Grants Management Food Safety - Center of Excellence 3.0 PROGRAM SUBTOTALS 3.0 3,266.0 1.5 900.0 8,498.0 3.0 1.0 135.0 45.0 1.0 1.0 51.0 90.00 2.0 0.167 102.0 15.0 15.0 1,350.0 3.1 4,185.0 1.0 1.0 1.0 4.0 4.0 1.0 4.0 4.0 4.0 1.0 4.0 4.0 4.0 4.0 90.0 90.0 90.0 360.0 360.0 90.0 360.0 360.0 360.0 90.0 360.0 360.0 360.0 360.0 5,271.0 1.7 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 153.0 135.0 135.0 540.0 540.0 135.0 540.0 540.0 540.0 135.0 540.0 540.0 540.0 540.0 10,035.0 4.0 12.0 12.0 1.5 18.0 18.0 7.13779240661 23,312.0 3.29774133784 76,877.0 Reviewers Notes: - Methodology used to calculate annual burden hours is as folllows: Estimated No. of Respondents1 x Frequency of Response per Respondent x Estimated Hrs per Response2. The hourly wage rate is an hourly mean wage for education-related occupations for functions performed by State agency and local agency program staff. Estimated No. Frequency of Affected Worksheet Total Annual Estimated Hrs Annual Title of Worksheet of Response per Current OMB Public Number Response per Response Burden Hrs 1 2 Respondents Respondent Control Number Reviewers Notes: - Methodology used to calculate annual burden hours is as folllows: Estimated No. of Respondents1 x Frequency of Response per Respondent x Estimated Hrs per Response2. The hourly wage rate is an hourly mean wage for education-related occupations for functions performed by State agency and local agency program staff. - Additional tabs are provided as summaries for Control Numbers with more than one form in the collection. SF 425 Estimates Current OMB Control Number 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 Workshe et Number Title of Worksheet SF-425 SF-425 SF-425 SF-425 SF-425 SF 425 SF 425 SF 425 SF 425 SF 425 SF 425 SF-425 SF-425 NSLP SBP SMP CACFP SFSP CN Team Nutrition CN - Administrative Review & Training (I) CN - Administrative Review & Training (II) CN - Summer Food Service Program Pilot Programs CN - Direct Certification & Verfication CN - CACFP Child Care Wellness Grants CN Direct Certification and Improvement CN National School Lunch Program Equipment Grants 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 SF-425 SF-425 SF-425 SF-425 SF-425 SF-425 SF-425 SF-425 SF-425 SF-425 SF-425 SF-425 SF-425 SF-425 SF-425 SF-425 CN National Food Service Management Institute (FSMI) CN FSMI Produce Safety University Support CN FSMI Food Safety CN FSMI General Education CN Community Gardens Pilot Program CN Hunger-Free Community Grants SNAP Outreach SNAP Health and Census Pilot SNAP Participation SNAP Increasing Participation Among Elderly SNAP Healthy Incentives CSFP FDPNE FDPIR-NET FDPIR TEFAP - Infrastructure Estimate Frequency of Total Annual d No. of Response per Response Respond Respondent ents 57.0 4.0 228.0 57.0 4.0 228.0 57.0 4.0 228.0 55.0 4.0 220.0 53.0 4.0 212.0 57.0 4.0 228.0 57.0 2.0 114.0 57.0 4.0 228.0 57.0 4.0 228.0 57.0 4.0 228.0 57.0 4.0 228.0 57.0 4.0 228.0 57.0 4.0 228.0 Page 5 of 13 1.0 1.0 1.0 1.0 150.0 150.0 53.0 53.0 53.0 53.0 53.0 42.0 111.0 111.0 111.0 150.0 4.0 4.0 4.0 4.0 4.0 4.0 4.0 4.0 4.0 4.0 4.0 1.0 4.0 1.0 4.0 4.0 4.0 4.0 4.0 4.0 600.0 600.0 212.0 212.0 212.0 212.0 212.0 42.0 444.0 111.0 444.0 600.0 Estimated Hrs per Response Annual Burden Hrs 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 342.0 342.0 342.0 330.0 318.0 342.0 171.0 342.0 342.0 342.0 342.0 342.0 342.0 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 6.0 6.0 6.0 6.0 900.0 900.0 318.0 318.0 318.0 318.0 318.0 63.0 666.0 166.5 666.0 900.0 SF 425 Estimates 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 0348-0061 Total SF-425 SF-425 SF-425 SF-425 SF-425 SF-425 SF-425 SF-425 SF-425 SF-425 SF-425 SF-425 SF-425 SF-425 WIC Breastfeeding Peer Counseling WIC General Infrastructure WIC General Infrastructure State Agency Model WIC State Agency Model WIC State to State Technical Assistance WIC Technology State Agency Model WIC Special Project Full Grant WIC Special Project Concept Grant WIC Breastfeeding Performance Bonus WIC Electronic Benefits Transfer ARRA WIC Electronic Benefits Transfer ARRA WIC State Agency Model ARRA WIC Technology State Agency Model Food Safety - Center of Excellence Page 6 of 13 90.0 90.0 90.0 90.0 90.0 90.0 90.0 90.0 90.0 90.0 90.0 90.0 90.0 3.0 150.0 1.0 1.0 4.0 4.0 1.0 4.0 4.0 4.0 1.0 4.0 4.0 4.0 4.0 4.0 90.0 90.0 360.0 360.0 90.0 360.0 360.0 360.0 90.0 360.0 360.0 360.0 360.0 12.0 10,355.0 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 1.5 135.0 135.0 540.0 540.0 135.0 540.0 540.0 540.0 135.0 540.0 540.0 540.0 540.0 18.0 15,532.5 0025 FNS 101 AND 191 Current OMB Control Number Worksheet Number 0584-0025 FNS-101 0584-0025 FNS-101 0584-0025 FNS-191 Total Title of Worksheet Participation in Food Programs-By Race Participation in Food Programs-By Race CSFP Racial/Ethnic Group Participation Estimated No. of Respondents Frequency of Response per Respondent Total Annual Response Estimated Hrs per Response Annual Burden Hrs 2,719.0 1.0 2,719.0 2.0 5,438.0 111.0 1.0 111.0 2.4 268.0 192.0 1.0 192.0 2.0 2719 Page 7 of 13 3,022.0 384.0 6,090.0 0045 FNS 798 and 798A Current OMB Control Number Worksheet Number 0584-0045 FNS-798 0584-0045 Total FNS-798A Title of Worksheet WIC Financial Management and Participation Report Addendum to WIC Financial Management and Participation Report - NSA Expenditures Estimated No. Frequency of Total Annual Estimated Hrs of Response per Response per Response Respondents Respondent Annual Burden Hrs 90.0 15.0 1,350.0 3.1 4,185.0 90.0 90 1.0 90.0 1,440.0 1.7 153.0 4,338.0 Page 8 of 13 0081 FNS 388 and 388A Current OMB Worksheet Title of Worksheet Control Number Number 0584State Issuance and Participation 0081 FNS-388 Estimates 0584Project Area Issuance and 0081 FNS-388A Participation Total Estimated No. Frequency of Total Annual of Response per Response Respondents Respondent Estimated Hrs per Response Annual Burden Hrs 53.0 11.3 600.0 5.7 3,390.0 53.0 2.3 120.0 14.8 1,779.6 53 Page 9 of 13 720.0 5,169.6 0083 fns 366A-B Current OMB Control Number Worksheet Number 0584-0083 FNS-366A 0584-0083 FNS-366B Total Title of Worksheet Program and Budget Summary Statement: Budget Projection Program and Budget Summary Statement: Program Activity Statement Estimated No. Frequency of Total Annual Estimated Hrs of Response per Response per Response Respondents Respondent 53.0 1.0 53.0 53 1.0 ---- Page 10 of 13 53.0 53.0 106.0 ---- Annual Burden Hrs 13.0 689.0 24.5 1,299.3 1,988.3 0293 FNS 152, 153 & 667 Current OMB Control Number Worksheet Number 0584-0293 FNS-667 0584-0293 FNS-667 0584-0293 FNS-152 0584-0293 Total FNS-153 Title of Worksheet ARRA-Report of The Emergency Food Assistance Programs (TEFAP) Administrative Costs Report of The Emergency Food Assistance Programs (TEFAP) Administrative Costs Monthly Distribution of Donated Food to Family Units Monthly Report of the CSFP and Quarterly Administrative Financial Status Report Estimated No. Frequency of Total Annual Estimated Hrs of Response per Response per Response Respondents Respondent Annual Burden Hrs 0.0 removed 55.0 0.0 0.0 0.0 55.0 5.0 275.0 3.5 962.5 97.0 12.0 1,164.0 2.5 2,910.0 20.0 12.0 240.0 6.3 1,512.0 111 1,679.0 Page 11 of 13 5,384.5 0447 FNS 203 & 683A Current OMB Control Number Worksheet Number 0584-0447 FNS-683a 0584-0447 FNS-203 Total Title of Worksheet WIC Farmers' Market Nutrition Program (FMNP) Annual Financial Report WIC Farmers' Market Nutrition Program Report Estimated No. Frequency of Total Annual of Response per Response Respondents Respondent 45.0 1.0 45.0 1.0 46 45.0 3.0 45.0 1.0 90.0 Page 12 of 13 Estimated Hrs per Response Annual Burden Hrs 135.0 45.0 180.0 NEW FNS 778-778A Estimate Estimated No. Frequency of Total Annual Current OMB Worksheet Title of d Hrs per of Response per Annual Burden Control Number Worksheet Respons Respondents Respondent Response Hrs Number e 0584-NEW FNS-778 SNAP 53.0 4.0 212.0 16.8 3,561.6 0584-NEW FNS-778a SNAP 7.0 4.0 28.0 1.0 28.0 Total 53 240.0 Page 13 of 13 3,589.6