Information Collection

Recordkeeping Only: Program & Budget Summary Statement FNS 366A; FNS 366B

IC 2990 under ICR 201703-0584-005 · OMB 0584-0083.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0083 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
FNS-366A.pdf FNS 366 A	IC Document
FNS-366B.pdf FNS 366 B	IC Document
SF-425.pdf SF 425	IC Document
0584-0594 FPRS PBStatement _ExpDatDisplayed 6-30-2019.pdf FPRS PBS	IC Document
Appendix A1 FNS 366 A Screenshot in FPRS april 17 2017.docx FNS 366A Screenshot in FPRS	IC Document
Appendix A2 FNS 366 B Screenshot in FPRS april 17 2017.docx FNS 366B Screenshot in FPRS	IC Document
Appendix 4 - SF-425 FNS Screenshot in FPRS.pdf SF 425 Screenshot in FPRS	IC Document

IC Title:

Recordkeeping Only: Program & Budget Summary Statement FNS 366A; FNS 366B

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 7 CFR 274.2 7 CFR 272.2 7 CFR 274.12

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

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	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	106	-813	919
Annual IC Time Burden (Hours)	5	-2,749	2,754
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
FNS 366 A	FNS-366A.pdf	03/27/2017
FNS 366 B	FNS-366B.pdf	03/27/2017
SF 425	SF-425.pdf	03/27/2017
FPRS PBS	0584-0594 FPRS PBStatement _ExpDatDisplayed 6-30-2019.pdf	03/27/2017
FNS 366A Screenshot in FPRS	Appendix A1 FNS 366 A Screenshot in FPRS april 17 2017.docx	04/24/2017
FNS 366B Screenshot in FPRS	Appendix A2 FNS 366 B Screenshot in FPRS april 17 2017.docx	04/24/2017
SF 425 Screenshot in FPRS	Appendix 4 - SF-425 FNS Screenshot in FPRS.pdf	04/24/2017

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.