Food Programs Reporting System (FPRS)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form FNS 366 B Program and Budget Summary Statement	Form and Instruction	New	Available
Form FNS-834 (screensho State Agency (NSLP/SNAP) Direct Certification Rate Data Element Report	Form and Instruction	Modified	Available
Form FNS-834 (screensho State Agency (NSLP/SNAP) Direct Certification Rate Data Element Report	Form and Instruction	Modified	Repair queued
Form FNS-834 State Agency (NSLP/SNAP) Direct Certification Rate Data Element Report (FNS-834)	Form and Instruction	Modified	Available
Form FNS-640 (A/B) (scr Administrative Review Report	Form and Instruction	Modified	Repair queued
Form FNS 640 (A/B) (scr Administrative Review Report	Form and Instruction	Modified	Available
Form FNS 640 (A/B) (scr Administrative Review Report	Form and Instruction	Modified	Available
Form FNS-874 (screensho Local Educational Agency Second Review of Applications Report	Form and Instruction	Modified	Available
Form FNS-874 (screensho Local Educational Agency Second Review of Applications Report	Form and Instruction	Modified	Available
Form FNS-874 (screensho Local Educational Agency Second Review of Applications Report	Form and Instruction	Modified	Available
Form FNS-874 (screensho Local Educational Agency Second Review of Applications Report	Form and Instruction	Modified	Repair queued
Form FNS-874 (screensho Local Educational Agency Second Review of Applications Report	Form and Instruction	Modified	Available
Form FNS-874 (screensho Local Educational Agency Second Review of Applications Report	Form and Instruction	Modified	Available
Form FNS-874 (screensho Local Educational Agency Second Review of Applications Report	Form and Instruction	Modified	Available
Form FNS-874 (screensho Local Educational Agency Second Review of Applications Report	Form and Instruction	Modified	Repair queued
Form FNS-874 (screensho Local Educational Agency Second Review of Applications Report	Form and Instruction	Modified	Available
Form FNS-874 (screensho Local Educational Agency Second Review of Applications Report	Form and Instruction	Modified	Available
Form FNS-742 (screensho School Food Authority (SFA) Verification Collection Report	Form and Instruction	Modified	Repair queued
Form FNS-742 (screensho School Food Authority (SFA) Verification Collection Report	Form and Instruction	Modified	Available
Form FNS-742 (screensho School Food Authority (SFA) Verification Collection Report	Form and Instruction	Modified	Repair queued
Form FNS-742 (screensho School Food Authority (SFA) Verification Collection Report	Form and Instruction	Modified	Available
Form FNS-742 FNS-742 School Food Authority (SFA) Verification Collection Report Upload Template	Form	Modified	Available
Form FNS-828 (screensho School Food Authority Paid Lunch Price Report	Form and Instruction	Modified	Available
Form FNS-828 (screensho School Food Authority Paid Lunch Price Report	Form and Instruction	Modified	Available
Form FNS-683A (screensh Senior Farmers' Market Nutrition Program (SFMNP) Annual Financial and Program Data Report	Form and Instruction	Modified	Available
Form FNS-683A (screensh Senior Farmers' Market Nutrition Program (SFMNP) Annual Financial and Program Data Report	Form and Instruction	Modified	Available
Form FNS 683a (screensh Senior Farmers' Market Nutrition Program (SFMNP) Annual Financial and Program Data Report	Form and Instruction	Modified	Available
Form FNS 778 & 778a (sc Federal Financial Report (SNAP OPERATIONS)	Form and Instruction	Modified	Repair queued
Form FNS 778 & 778a (sc Federal Financial Report (SNAP OPERATIONS)	Form and Instruction	Modified	Repair queued
Form FNS 778 & 778a (sc Federal Financial Report (SNAP OPERATIONS)	Form and Instruction	Modified	Available
Form FNS 778 & 778A (sc Federal Financial Report (SNAP OPERATIONS)	Form and Instruction	Modified	Available
Form FNS 778 & 778a (sc Federal Financial Report (SNAP OPERATIONS)	Form and Instruction	Modified	Available
Form FNS 778 & 778a (sc Federal Financial Report (SNAP OPERATIONS)	Form and Instruction	Modified	Repair queued
Form FNS 648 (screensho WIC Local Agency Directory	Form and Instruction	Modified	Available
Form FNS 648 (screensho WIC Local Agency Directory	Form and Instruction	Modified	Available
Form FNS 798/798A (scre WIC Financial Management and Participation Report	Form and Instruction	Modified	Available
Form FNS 798/798A (scre WIC Financial Management and Participation Report	Form and Instruction	Modified	Repair queued
Form FNS 798/798A (scre WIC Financial Management and Participation Report	Form and Instruction	Modified	Available
Form FNS 798/798A (scre WIC Financial Management and Participation Report	Form and Instruction	Modified	Available
Form FNS 798-798A (scre WIC Financial Management and Participation Report	Form and Instruction	Modified	Available
Form FNS798/798A (scree WIC Financial Management and Participation Report	Form and Instruction	Modified	Available
Form FNS 789/798A (scre WIC Financial Management and Participation Report	Form and Instruction	Modified	Repair queued
Form FNS 798/798A (scre WIC Financial Management and Participation Report	Form and Instruction	Modified	Available
Form FNS 759 EARS (scre SNAP Education & Admin Reporting System (EARS)	Form and Instruction	Modified	Available
Form FNS 759 EARS (scre SNAP Education & Admin Reporting System (EARS)	Form and Instruction	Modified	Available
Form FNS 759 EARS (scre SNAP Education & Admin Reporting System (EARS)	Form and Instruction	Modified	Available
Form FNS 583 (screensho SNAP Employment and Training Program Activity Report	Form and Instruction	Modified	Available
Form FNS 292B (screensh Disaster Relief SNAP Benefit Issuance	Form and Instruction	Modified	Available
Form FNS 292A (screensh Disaster Relief (Commodities Distrubution) Report of Commodity Distrubution for DR	Form and Instruction	Modified	Repair queued
Form FNS 366 A Program and Budget Summary Statement Budget Projection	Form and Instruction	Modified	Repair queued
Form FNS 366 A Program and Budget Summary Statement Budget Projection	Form and Instruction	Modified	Available
Form FNS 366A (page 1) Program and Budget Summary Statement Budget Projection	Form and Instruction	Modified	Repair queued
Form FNS 366 A (Screens Program and Budget Summary Statement: Budget Projection	Form and Instruction	Modified	Available
Form FNS 209 Screenshot Status of Claims Against Households	Form and Instruction	Modified	Available
Form FNS 209 Screenshot Status of Claims Against Households	Form and Instruction	Modified	Available
Form FNS777 (screenshot Financial Status Report	Form and Instruction	Modified	Repair queued
Form FNS777 (screenshot Financial Status Report	Form and Instruction	Modified	Available
Form FNS777 (screenshot Financial Status Report	Form and Instruction	Modified	Available
Form FNS777 (screenshot Financial Status Report	Form and Instruction	Modified	Available
Form FNS777 (screenshot Financial Status Report	Form and Instruction	Modified	Available
Form FNS777 (screenshot Financial Status Report	Form and Instruction	Modified	Repair queued
Form FNS777 (screenshot Financial Status Report	Form and Instruction	Modified	Repair queued
Form FNS777 (screenshot Financial Status Report	Form and Instruction	Modified	Repair queued
Form FNS777 (screenshot Financial Status Report	Form and Instruction	Modified	Available
Form FNS777 (screenshot Financial Status Report	Form and Instruction	Modified	Available
Form FNS777 (screenshot Financial Status Report	Form and Instruction	Modified	Available
Form FNS777 (screenshot Financial Status Report	Form and Instruction	Modified	Repair queued
Form FNS777 (screenshot Financial Status Report	Form and Instruction	Modified	Available
Form FNS 777 (screensho Financial Status Report	Form and Instruction	Modified	Repair queued
Form FNS 667 (remarks s Report of The Emergency Food Assistance Program (TEFAP) Administrative Costs	Form and Instruction	Modified	Repair queued
Form FNS 153 (screensho Monthly Report of the CSFP and Quarterly Administrative Financial Status Report	Form and Instruction	Modified	Available
Form FNS 152 (screensho Monthly Distribution of Donated Food to Family Units	Form and Instruction	Modified	Available
Form FNS 667 (screensho Report of The Emergency Food Assistance Programs (TEFAP) Administrative Costs	Form and Instruction	Modified	Available
Form FNS 153 (screensho Monthly Report of the CSFP and Quarterly Administrative Financial Status Report	Form and Instruction	Modified	Repair queued
Form FNS 152 (screensho Monthly Distribution of Donated Food to Family Units	Form and Instruction	Modified	Available
Form FNS 44 Report of Child and Adult Care Food Program	Form and Instruction	Modified	Available
Form FNS 44 Report of Child and Adult Care Food Program	Form and Instruction	Modified	Available
Form FNS 44 Report of Child and Adult Care Food Program	Form and Instruction	Modified	Repair queued
Form FNS 101 Participation in Food Programs-By Race	Form and Instruction	Modified	Available
Form FNS 191 CSFP Racial/Ethnic Group Participation	Form and Instruction	Modified	Available
Form FNS 388 (SNAP-TERR State Issuance and Participation Estimates	Form and Instruction	Modified	Repair queued
Form FNS 388 (SNAP-TERR State Issuance and Participation Estimates	Form and Instruction	Modified	Repair queued
Form FNS 388 (SNAP-TERR State Issuance and Participation Estimates	Form and Instruction	Modified	Available
Form FNS 388 State Issuance and Participation Estimates	Form and Instruction	Modified	Available
Form FNS 388a SNAP Project Area Data Format	Form and Instruction	Modified	Available
Form FNS 683B (remarks WIC FARMERS' MARKET NUTRITION PROGRAM (FMNP) ANNUAL FINANCIAL AND PROGRAM DATA REPORT	Form and Instruction	Modified	Available
Form FNS 683 B WIC FARMERS' MARKET NUTRITION PROGRAM (FMNP) ANNUAL FINANCIAL AND PROGRAM DATA REPORT	Form and Instruction	Modified	Available
Form SF 425 Screenshots Federal Financial Report	Form and Instruction	Modified	Available
Form SF 425 (screenshot Federal Financial Report	Form and Instruction	Modified	Available
Form SF 425 (screenshot Federal Financial Report	Form and Instruction	Modified	Repair queued
Form FNS 46 Issuance Reconciliation Report (remarks section)	Form and Instruction	Modified	Available
Form FNS 46 Issuance Reconciliation Report	Form and Instruction	Modified	Available
Form FNS 418 Worksheet REPORT OF THE SUMMER FOOD SERVICE PROGRAM FOR CHILDREN	Form and Instruction	Modified	Available
Form FNS 418 Worksheet REPORT OF THE SUMMER FOOD SERVICE PROGRAM FOR CHILDREN	Form and Instruction	Modified	Repair queued
Form FNS 418 Worksheet REPORT OF THE SUMMER FOOD SERVICE PROGRAM FOR CHILDREN	Form and Instruction	Modified	Available
Form FNS 13 Annual Report of State Revenue Matching	Form and Instruction	Modified	Repair queued
Form FNS-10 - PART B Report of School Program Operations	Form	Modified	Available
Form FNS-10 - PART A.jp Report of School Program Operations	Form and Instruction	Modified	Repair queued
Working with Cells.png	Supplementary Document	Uploaded 2019-09-24	Repair queued
User Access Request Form.png	Supplementary Document	Uploaded 2019-09-24	Available
Unlock.png	Supplementary Document	Uploaded 2019-09-24	Repair queued
Submit Revise.png	Supplementary Document	Uploaded 2019-09-24	Available
Submission Studio.png	Supplementary Document	Uploaded 2019-09-24	Repair queued
Simplified Studio.png	Supplementary Document	Uploaded 2019-09-24	Repair queued
Search.png	Supplementary Document	Uploaded 2019-09-24	Available
Rejected Before Posting.png	Supplementary Document	Uploaded 2019-09-24	Repair queued
Rejected Before Certification.png	Supplementary Document	Uploaded 2019-09-24	Available
Rejected After Posting.png	Supplementary Document	Uploaded 2019-09-24	Available
Program Management.png	Supplementary Document	Uploaded 2019-09-24	Repair queued
Online Forms Navigation.png	Supplementary Document	Uploaded 2019-09-24	Available
NSLP Sate Revenue Matching Requirement.png	Supplementary Document	Uploaded 2019-09-24	Available
Navigation Bar.png	Supplementary Document	Uploaded 2019-09-24	Available
Logging On to FPRS.png	Supplementary Document	Uploaded 2019-09-24	Available
Logging off of FPRS.png	Supplementary Document	Uploaded 2019-09-24	Available
Logging off Due to Session Timeout.png	Supplementary Document	Uploaded 2019-09-24	Available
Introduction to FPRS.png	Supplementary Document	Uploaded 2019-09-24	Available
Homepage_CBT.PNG	Supplementary Document	Uploaded 2019-09-24	Available
Home Page.png	Supplementary Document	Uploaded 2019-09-24	Repair queued
History and Audit.png	Supplementary Document	Uploaded 2019-09-24	Repair queued
Helpful Hints.png	Supplementary Document	Uploaded 2019-09-24	Available
Hardware and Software Requirements.png	Supplementary Document	Uploaded 2019-09-24	Repair queued
FPRS Workflow.png	Supplementary Document	Uploaded 2019-09-24	Available
Form Management.png	Supplementary Document	Uploaded 2019-09-24	Repair queued
Food Group Management.png	Supplementary Document	Uploaded 2019-09-24	Repair queued
Excel Sheet.png	Supplementary Document	Uploaded 2019-09-24	Available
Commodity Report.png	Supplementary Document	Uploaded 2019-09-24	Repair queued
Chnging Your Password.png	Supplementary Document	Uploaded 2019-09-24	Available
Changing Your Email Address.png	Supplementary Document	Uploaded 2019-09-24	Repair queued
Analysis Sheet.png	Supplementary Document	Uploaded 2019-09-24	Available
Action Buttons.png	Supplementary Document	Uploaded 2019-09-24	Available
Access Permissions.png	Supplementary Document	Uploaded 2019-09-24	Available
CN legislative authorities - all forms..docx	Supplementary Document	Uploaded 2019-09-13	Available
OMB Bulletin_19_01 Leg Auth for Fed Financial Reporting Form SF425.pdf	Supplementary Document	Uploaded 2019-09-12	Available
Leg Auth for SF 425.pdf	Supplementary Document	Uploaded 2019-09-12	Available
FNS-798 & FNS-648 reg citation.pdf	Supplementary Document	Uploaded 2019-09-12	Available
FNS-777(SAE) reg citation.doc	Supplementary Document	Uploaded 2019-09-13	Available
FNS-777 e-cfr reg citation.pdf	Supplementary Document	Uploaded 2019-09-12	Available
FNS-759 reg citation.pdf	Supplementary Document	Uploaded 2019-09-12	Repair queued
FNS-683A reg citation.pdf	Supplementary Document	Uploaded 2019-09-12	Available
FNS-683 & FNS-203 reg citation.pdf	Supplementary Document	Uploaded 2019-09-12	Available
FNS-667 reg citation.pdf	Supplementary Document	Uploaded 2019-09-12	Available
FNS-583 reg citation.pdf	Supplementary Document	Uploaded 2019-09-12	Available
FNS-418 reg citation.pdf	Supplementary Document	Uploaded 2019-09-12	Available
FNS-366 A&B.pdf	Supplementary Document	Uploaded 2019-09-12	Available
FNS-292 reg citation.pdf	Supplementary Document	Uploaded 2019-09-12	Available
FNS-209 reg citation.pdf	Supplementary Document	Uploaded 2019-09-12	Available
FNS-191 reg citation.pdf	Supplementary Document	Uploaded 2019-09-12	Available
FNS-152 & FNS-153 reg citation.pdf	Supplementary Document	Uploaded 2019-09-12	Available
FNS-101 reg citation.pdf	Supplementary Document	Uploaded 2019-09-12	Available
FNS-46 & FNS-388 e-cfr reg citation.pdf	Supplementary Document	Uploaded 2019-09-12	Available
FNS-44 e-cfr reg citation.pdf	Supplementary Document	Uploaded 2019-09-12	Available
FNS-13 e-cfr reg citation.pdf	Supplementary Document	Uploaded 2019-09-12	Available
FNS-10 e-cfr reg citation.pdf	Supplementary Document	Uploaded 2019-09-12	Available
Welcome Page.jpg	Supplementary Document	Uploaded 2019-09-12	Available
Submit_Revise.jpg	Supplementary Document	Uploaded 2019-09-12	Repair queued
Search.jpg	Supplementary Document	Uploaded 2019-09-12	Repair queued
Reject Posted Submission.jpg	Supplementary Document	Uploaded 2019-09-12	Available
QTR-SFA-CERT_Report.jpg	Supplementary Document	Uploaded 2019-09-12	Available
QTR-SFA-CERT_Remarks.jpg	Supplementary Document	Uploaded 2019-09-12	Available
Post Submission.jpg	Supplementary Document	Uploaded 2019-09-12	Available
Landing Page.jpg	Supplementary Document	Uploaded 2019-09-12	Available
Due Date.jpg	Supplementary Document	Uploaded 2019-09-12	Available
Certify Submission.jpg	Supplementary Document	Uploaded 2019-09-12	Repair queued
About FPRS.jpg	Supplementary Document	Uploaded 2019-09-12	Available
WIC Local Agency_Clinic Management.jpg	Supplementary Document	Uploaded 2019-09-12	Available
Update Region Information.jpg	Supplementary Document	Uploaded 2019-09-12	Available
Update Headquarters Information.jpg	Supplementary Document	Uploaded 2019-09-12	Available
Session Time out.jpg	Supplementary Document	Uploaded 2019-09-12	Available
Rate Management.jpg	Supplementary Document	Uploaded 2019-09-12	Available
Program Management Page.jpg	Supplementary Document	Uploaded 2019-09-12	Repair queued
Overdue Submission.jpg	Supplementary Document	Uploaded 2019-09-12	Available
NSLP State Revenue Matching Requirement.jpg	Supplementary Document	Uploaded 2019-09-12	Available
LookUp Value Management.jpg	Supplementary Document	Uploaded 2019-09-12	Available
Help.jpg	Supplementary Document	Uploaded 2019-09-12	Available
Form Management.jpg	Supplementary Document	Uploaded 2019-09-12	Available
Food Group Management.jpg	Supplementary Document	Uploaded 2019-09-12	Repair queued
eAuth Sign In page 2.JPG	Supplementary Document	Uploaded 2019-09-12	Available
eAuth Sign In page 1.JPG	Supplementary Document	Uploaded 2019-09-12	Available
Create Agency Profile.jpg	Supplementary Document	Uploaded 2019-09-12	Repair queued
Control Value Management.jpg	Supplementary Document	Uploaded 2019-09-12	Repair queued
Contact Us.jpg	Supplementary Document	Uploaded 2019-09-12	Repair queued
Commodity Report.jpg	Supplementary Document	Uploaded 2019-09-12	Available
Commodity Management.jpg	Supplementary Document	Uploaded 2019-09-12	Repair queued
CBT.JPG	Supplementary Document	Uploaded 2019-09-12	Repair queued
Application Singed out.jpg	Supplementary Document	Uploaded 2019-09-12	Repair queued
Agency Search.jpg	Supplementary Document	Uploaded 2019-09-12	Repair queued
Add Commodity.jpg	Supplementary Document	Uploaded 2019-09-12	Repair queued
Active List.jpg	Supplementary Document	Uploaded 2019-09-12	Available
Forms Purpose 9-24-19_.xls	Supplementary Document	Uploaded 2019-09-27	Repair queued
Supporting Statement part B 9-24-19.docx	Supporting Statement B	Uploaded 2019-09-24	Available
Privacy Assessment form.pdf	Supplementary Document	Uploaded 2019-09-09	Available
Burden chart 9-25-2019.xls	Supplementary Document	Uploaded 2019-09-30	Available
Supporting Statement 9-30-2019 PRAO commentsfinal.doc	Supporting Statement A	Uploaded 2019-09-30	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
237913	Worksheet 366B OMB# 0083	Form and Instruction	New	Program and Budget Summary Statement
237913	Worksheet 366B OMB# 0083	Instruction	New
225044	FNS-834	Form and Instruction	Modified	State Agency (NSLP/SNAP) Direct Certification Rate Data Element Report
225044	FNS-834	Form and Instruction	Modified	State Agency (NSLP/SNAP) Direct Certification Rate Data Element Report
225044	FNS-834	Form and Instruction	Modified	State Agency (NSLP/SNAP) Direct Certification Rate Data Element Report (FNS-834)
225044	FNS-834	Instruction	Modified
223716	FNS 640	Form and Instruction	Modified	Administrative Review Report
223716	FNS 640	Form and Instruction	Modified	Administrative Review Report
223716	FNS 640	Form and Instruction	Modified	Administrative Review Report
223716	FNS 640	Instruction	Modified
219419	FNS-874	Form and Instruction	Modified	Local Educational Agency Second Review of Applications Report
219419	FNS-874	Form and Instruction	Modified	Local Educational Agency Second Review of Applications Report
219419	FNS-874	Form and Instruction	Modified	Local Educational Agency Second Review of Applications Report
219419	FNS-874	Form and Instruction	Modified	Local Educational Agency Second Review of Applications Report
219419	FNS-874	Form and Instruction	Modified	Local Educational Agency Second Review of Applications Report
219419	FNS-874	Form and Instruction	Modified	Local Educational Agency Second Review of Applications Report
219419	FNS-874	Form and Instruction	Modified	Local Educational Agency Second Review of Applications Report
219419	FNS-874	Form and Instruction	Modified	Local Educational Agency Second Review of Applications Report
219419	FNS-874	Form and Instruction	Modified	Local Educational Agency Second Review of Applications Report
219419	FNS-874	Form and Instruction	Modified	Local Educational Agency Second Review of Applications Report
219419	FNS-874	Instruction	Modified
219418	FNS-742	Form and Instruction	Modified	School Food Authority (SFA) Verification Collection Report
219418	FNS-742	Form and Instruction	Modified	School Food Authority (SFA) Verification Collection Report
219418	FNS-742	Form and Instruction	Modified	School Food Authority (SFA) Verification Collection Report
219418	FNS-742	Form and Instruction	Modified	School Food Authority (SFA) Verification Collection Report
219418	FNS-742	Form	Modified	FNS-742 School Food Authority (SFA) Verification Collection Report Upload Template
219418	FNS-742	Instruction	Modified
219236	FNS-828	Form and Instruction	Modified	School Food Authority Paid Lunch Price Report
219236	FNS-828	Form and Instruction	Modified	School Food Authority Paid Lunch Price Report
219236	FNS-828	Instruction	Modified
204872	Worksheet FNS 683A OMB# 0541	Form and Instruction	Modified	Senior Farmers' Market Nutrition Program (SFMNP) Annual Financial and Program Data Report
204872	Worksheet FNS 683A OMB# 0541	Form and Instruction	Modified	Senior Farmers' Market Nutrition Program (SFMNP) Annual Financial and Program Data Report
204872	Worksheet FNS 683A OMB# 0541	Form and Instruction	Modified	Senior Farmers' Market Nutrition Program (SFMNP) Annual Financial and Program Data Report
204872	Worksheet FNS 683A OMB# 0541	Instruction	Modified
204774	Worksheet FNS 778 AND 778A OMB# 0584-0594	Form and Instruction	Modified	Federal Financial Report (SNAP OPERATIONS)
204774	Worksheet FNS 778 AND 778A OMB# 0584-0594	Form and Instruction	Modified	Federal Financial Report (SNAP OPERATIONS)
204774	Worksheet FNS 778 AND 778A OMB# 0584-0594	Form and Instruction	Modified	Federal Financial Report (SNAP OPERATIONS)
204774	Worksheet FNS 778 AND 778A OMB# 0584-0594	Form and Instruction	Modified	Federal Financial Report (SNAP OPERATIONS)
204774	Worksheet FNS 778 AND 778A OMB# 0584-0594	Form and Instruction	Modified	Federal Financial Report (SNAP OPERATIONS)
204774	Worksheet FNS 778 AND 778A OMB# 0584-0594	Form and Instruction	Modified	Federal Financial Report (SNAP OPERATIONS)
204774	Worksheet FNS 778 AND 778A OMB# 0584-0594	Instruction	Modified
204753	Worksheet FNS 648 OMB# 0431	Form and Instruction	Modified	WIC Local Agency Directory
204753	Worksheet FNS 648 OMB# 0431	Form and Instruction	Modified	WIC Local Agency Directory
204753	Worksheet FNS 648 OMB# 0431	Instruction	Modified
204751	Worksheet FNS 798 and 798A OMB# 0045	Form and Instruction	Modified	WIC Financial Management and Participation Report
204751	Worksheet FNS 798 and 798A OMB# 0045	Form and Instruction	Modified	WIC Financial Management and Participation Report
204751	Worksheet FNS 798 and 798A OMB# 0045	Form and Instruction	Modified	WIC Financial Management and Participation Report
204751	Worksheet FNS 798 and 798A OMB# 0045	Form and Instruction	Modified	WIC Financial Management and Participation Report
204751	Worksheet FNS 798 and 798A OMB# 0045	Form and Instruction	Modified	WIC Financial Management and Participation Report
204751	Worksheet FNS 798 and 798A OMB# 0045	Form and Instruction	Modified	WIC Financial Management and Participation Report
204751	Worksheet FNS 798 and 798A OMB# 0045	Form and Instruction	Modified	WIC Financial Management and Participation Report
204751	Worksheet FNS 798 and 798A OMB# 0045	Form and Instruction	Modified	WIC Financial Management and Participation Report
204751	Worksheet FNS 798 and 798A OMB# 0045	Instruction	Modified
204673	Worksheet FNS 759 Revised Instructions for Clarity OMB# 0594 formerly 0542 March 2017	Form and Instruction	Modified	SNAP Education & Admin Reporting System (EARS)
204673	Worksheet FNS 759 Revised Instructions for Clarity OMB# 0594 formerly 0542 March 2017	Form and Instruction	Modified	SNAP Education & Admin Reporting System (EARS)
204673	Worksheet FNS 759 Revised Instructions for Clarity OMB# 0594 formerly 0542 March 2017	Form and Instruction	Modified	SNAP Education & Admin Reporting System (EARS)
204673	Worksheet FNS 759 Revised Instructions for Clarity OMB# 0594 formerly 0542 March 2017	Instruction	Modified
204669	Worksheet FNS 583 OMB# 0339	Form and Instruction	Modified	SNAP Employment and Training Program Activity Report
204669	Worksheet FNS 583 OMB# 0339	Instruction	Modified
204666	Worksheet FNS 292A and 292B OMB# 0037	Form and Instruction	Modified	Disaster Relief SNAP Benefit Issuance
204666	Worksheet FNS 292A and 292B OMB# 0037	Form and Instruction	Modified	Disaster Relief (Commodities Distrubution) Report of Commodity Distrubution for DR
204666	Worksheet FNS 292A and 292B OMB# 0037	Instruction	Modified
204662	Worksheet FNS 366A OMB# 0083	Form and Instruction	Modified	Program and Budget Summary Statement Budget Projection
204662	Worksheet FNS 366A OMB# 0083	Form and Instruction	Modified	Program and Budget Summary Statement Budget Projection
204662	Worksheet FNS 366A OMB# 0083	Form and Instruction	Modified	Program and Budget Summary Statement Budget Projection
204662	Worksheet FNS 366A OMB# 0083	Form and Instruction	Modified	Program and Budget Summary Statement: Budget Projection
204662	Worksheet FNS 366A OMB# 0083	Instruction	Modified
204659	Worksheet FNS 209 OMB# 0069	Form and Instruction	Modified	Status of Claims Against Households
204659	Worksheet FNS 209 OMB# 0069	Form and Instruction	Modified	Status of Claims Against Households
204659	Worksheet FNS 209 OMB# 0069	Instruction	Modified
204658	Worksheet FNS 777 OMB# 0067	Form and Instruction	Modified	Financial Status Report
204658	Worksheet FNS 777 OMB# 0067	Form and Instruction	Modified	Financial Status Report
204658	Worksheet FNS 777 OMB# 0067	Form and Instruction	Modified	Financial Status Report
204658	Worksheet FNS 777 OMB# 0067	Form and Instruction	Modified	Financial Status Report
204658	Worksheet FNS 777 OMB# 0067	Form and Instruction	Modified	Financial Status Report
204658	Worksheet FNS 777 OMB# 0067	Form and Instruction	Modified	Financial Status Report
204658	Worksheet FNS 777 OMB# 0067	Form and Instruction	Modified	Financial Status Report
204658	Worksheet FNS 777 OMB# 0067	Form and Instruction	Modified	Financial Status Report
204658	Worksheet FNS 777 OMB# 0067	Form and Instruction	Modified	Financial Status Report
204658	Worksheet FNS 777 OMB# 0067	Form and Instruction	Modified	Financial Status Report
204658	Worksheet FNS 777 OMB# 0067	Form and Instruction	Modified	Financial Status Report
204658	Worksheet FNS 777 OMB# 0067	Form and Instruction	Modified	Financial Status Report
204658	Worksheet FNS 777 OMB# 0067	Form and Instruction	Modified	Financial Status Report
204658	Worksheet FNS 777 OMB# 0067	Form and Instruction	Modified	Financial Status Report
204658	Worksheet FNS 777 OMB# 0067	Instruction	Modified
204625	Worksheet FNS 152, 153 & 667 OMB# 0293	Form and Instruction	Modified	Report of The Emergency Food Assistance Program (TEFAP) Administrative Costs
204625	Worksheet FNS 152, 153 & 667 OMB# 0293	Form and Instruction	Modified	Monthly Report of the CSFP and Quarterly Administrative Financial Status Report
204625	Worksheet FNS 152, 153 & 667 OMB# 0293	Form and Instruction	Modified	Monthly Distribution of Donated Food to Family Units
204625	Worksheet FNS 152, 153 & 667 OMB# 0293	Form and Instruction	Modified	Report of The Emergency Food Assistance Programs (TEFAP) Administrative Costs
204625	Worksheet FNS 152, 153 & 667 OMB# 0293	Form and Instruction	Modified	Monthly Report of the CSFP and Quarterly Administrative Financial Status Report
204625	Worksheet FNS 152, 153 & 667 OMB# 0293	Form and Instruction	Modified	Monthly Distribution of Donated Food to Family Units
204625	Worksheet FNS 152, 153 & 667 OMB# 0293	Instruction	Modified
204622	Worksheet FNS 44 OMB# 0055	Form and Instruction	Modified	Report of Child and Adult Care Food Program
204622	Worksheet FNS 44 OMB# 0055	Form and Instruction	Modified	Report of Child and Adult Care Food Program
204622	Worksheet FNS 44 OMB# 0055	Form and Instruction	Modified	Report of Child and Adult Care Food Program
204622	Worksheet FNS 44 OMB# 0055	Instruction	Modified
204621	Worksheet FNS 101 (3 respondents from CMNI and 2853 SLT & 191 (252 Respondents) OMB# 0025	Form and Instruction	Modified	Participation in Food Programs-By Race
204621	Worksheet FNS 101 (3 respondents from CMNI and 2853 SLT & 191 (252 Respondents) OMB# 0025	Form and Instruction	Modified	CSFP Racial/Ethnic Group Participation
204621	Worksheet FNS 101 (3 respondents from CMNI and 2853 SLT & 191 (252 Respondents) OMB# 0025	Instruction	Modified
204620	Worksheet FNS 388 and 388A OMB# 0081	Form and Instruction	Modified	State Issuance and Participation Estimates
204620	Worksheet FNS 388 and 388A OMB# 0081	Form and Instruction	Modified	State Issuance and Participation Estimates
204620	Worksheet FNS 388 and 388A OMB# 0081	Form and Instruction	Modified	State Issuance and Participation Estimates
204620	Worksheet FNS 388 and 388A OMB# 0081	Form and Instruction	Modified	State Issuance and Participation Estimates
204620	Worksheet FNS 388 and 388A OMB# 0081	Form and Instruction	Modified	SNAP Project Area Data Format
204620	Worksheet FNS 388 and 388A OMB# 0081	Instruction	Modified
204618	Worksheet FNS 683 B OMB# 0594	Form and Instruction	Modified	WIC FARMERS' MARKET NUTRITION PROGRAM (FMNP) ANNUAL FINANCIAL AND PROGRAM DATA REPORT
204618	Worksheet FNS 683 B OMB# 0594	Form and Instruction	Modified	WIC FARMERS' MARKET NUTRITION PROGRAM (FMNP) ANNUAL FINANCIAL AND PROGRAM DATA REPORT
204616	OMB# 4040-0014 SF 425	Form and Instruction	Modified	Federal Financial Report
204616	OMB# 4040-0014 SF 425	Form and Instruction	Modified	Federal Financial Report
204616	OMB# 4040-0014 SF 425	Form and Instruction	Modified	Federal Financial Report
204616	OMB# 4040-0014 SF 425	Instruction	Modified
203841	Worksheet FNS 46 OMB# 0080	Form and Instruction	Modified	Issuance Reconciliation Report (remarks section)
203841	Worksheet FNS 46 OMB# 0080	Form and Instruction	Modified	Issuance Reconciliation Report
203841	Worksheet FNS 46 OMB# 0080	Instruction	Modified
203832	Worksheet FNS 418 OMB# 0280	Form and Instruction	Modified	REPORT OF THE SUMMER FOOD SERVICE PROGRAM FOR CHILDREN
203832	Worksheet FNS 418 OMB# 0280	Form and Instruction	Modified	REPORT OF THE SUMMER FOOD SERVICE PROGRAM FOR CHILDREN
203832	Worksheet FNS 418 OMB# 0280	Form and Instruction	Modified	REPORT OF THE SUMMER FOOD SERVICE PROGRAM FOR CHILDREN
203831	Worksheet FNS 13 OMB#0075	Form and Instruction	Modified	Annual Report of State Revenue Matching
203831	Worksheet FNS 13 OMB#0075	Instruction	Modified
203829	Worksheet FNS 10 OMB# 0002	Form	Modified	Report of School Program Operations
203829	Worksheet FNS 10 OMB# 0002	Form and Instruction	Modified	Report of School Program Operations
203829	Worksheet FNS 10 OMB# 0002	Instruction	Modified

ICR Details

OMB Control No: 0584-0594	ICR Reference No: 201904-0584-002
Status: Historical Active	Previous ICR Reference No: 201703-0584-001
Agency/Subagency: USDA/FNS	Agency Tracking No: Renewal 2019
Title: Food Programs Reporting System (FPRS)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 07/14/2020
Retrieve Notice of Action (NOA)	Date Received in OIRA: 09/30/2019
Terms of Clearance: FNS may make changes to its address as a de minimis change.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2023	36 Months From Approved	07/31/2020
Responses	47,157	0	46,378
Time Burden (Hours)	102,044	0	104,749
Cost Burden (Dollars)	0	0	0

---

Abstract: FPRS facilitates data gathering for the reporting of data for the Special Supplemental Nutrition Program (SNAP) and the Special Nutrition Programs. FPRS is the primary collection point for program performance statistics and financial data from State agencies (SA), Indian Tribal Organizations (ITO), and U.S. Territories participating in the nutrition assistance programs. This information collection pertains to 20 FNS collections currently approved by OMB The reporting burdens for these collections will merge with FPRS once approved by OMB.

---

Authorizing Statute(s): None

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 36884	07/30/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 51509	09/30/2019
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 26

table that charts list of burden

IC Title	Form No.	Form Name
FNS 640	FNS 640 (A/B) (screenshot1), FNS-640 (A/B) (screenshot3), FNS 640 (A/B) (screenshot2)	Administrative Review Report ,   Administrative Review Report ,   Administrative Review Report
FNS-742	FNS-742, FNS-742 (screenshot 1), FNS-742 (screenshot2), FNS-742 (screenshot3), FNS-742 (screenshot4)	FNS-742 School Food Authority (SFA) Verification Collection Report Upload Template ,   School Food Authority (SFA) Verification Collection Report ,   School Food Authority (SFA) Verification Collection Report ,   School Food Authority (SFA) Verification Collection Report ,   School Food Authority (SFA) Verification Collection Report
FNS-828	FNS-828 (screenshot 1), FNS-828 (screenshot 2)	School Food Authority Paid Lunch Price Report ,   School Food Authority Paid Lunch Price Report
FNS-834	FNS-834, FNS-834 (screenshot1), FNS-834 (screenshot2)	State Agency (NSLP/SNAP) Direct Certification Rate Data Element Report (FNS-834) ,   State Agency (NSLP/SNAP) Direct Certification Rate Data Element Report ,   State Agency (NSLP/SNAP) Direct Certification Rate Data Element Report
FNS-874	FNS-874 (screenshot1), FNS-874 (screenshot5), FNS-874 (screenshot10), FNS-874 (screenshot2), FNS-874 (screenshot7), FNS-874 (screenshot9), FNS-874 (screenshot3), FNS-874 (screenshot4), FNS-874 (screenshot 6), FNS-874 (screenshot8)	Local Educational Agency Second Review of Applications Report ,   Local Educational Agency Second Review of Applications Report ,   Local Educational Agency Second Review of Applications Report ,   Local Educational Agency Second Review of Applications Report ,   Local Educational Agency Second Review of Applications Report ,   Local Educational Agency Second Review of Applications Report ,   Local Educational Agency Second Review of Applications Report ,   Local Educational Agency Second Review of Applications Report ,   Local Educational Agency Second Review of Applications Report ,   Local Educational Agency Second Review of Applications Report
OMB# 4040-0014 SF 425	SF 425 (screenshot page 1), SF 425 (screenshot page 2), SF 425 Screenshots (remarks section)	Federal Financial Report ,   Federal Financial Report ,   Federal Financial Report
Worksheet 366B OMB# 0083	FNS 366 B	Program and Budget Summary Statement
Worksheet FNS 366A OMB# 0083	FNS 366 A (Screenshot), FNS 366A (page 1), FNS 366 A, FNS 366 A	Program and Budget Summary Statement: Budget Projection ,   Program and Budget Summary Statement Budget Projection ,   Program and Budget Summary Statement Budget Projection ,   Program and Budget Summary Statement Budget Projection
Worksheet FNS 10 OMB# 0002	FNS-10 - PART A.jpg, FNS-10 - PART B	Report of School Program Operations ,   Report of School Program Operations
Worksheet FNS 101 (3 respondents from CMNI and 2853 SLT & 191 (252 Respondents) OMB# 0025	FNS 101, FNS 191	CSFP Racial/Ethnic Group Participation ,   Participation in Food Programs-By Race
Worksheet FNS 13 OMB#0075	FNS 13	Annual Report of State Revenue Matching
Worksheet FNS 152, 153 & 667 OMB# 0293	FNS 152 (screenshot 2), FNS 153 (screenshot 1), FNS 667 (screenshot), FNS 152 (screenshot 1), FNS 153 (screenshot 2), FNS 667 (remarks section)	Monthly Distribution of Donated Food to Family Units ,   Monthly Report of the CSFP and Quarterly Administrative Financial Status Report ,   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 ,   Report of The Emergency Food Assistance Program (TEFAP) Administrative Costs
Worksheet FNS 209 OMB# 0069	FNS 209 Screenshot, FNS 209 Screenshot	Status of Claims Against Households ,   Status of Claims Against Households
Worksheet FNS 292A and 292B OMB# 0037	FNS 292A (screenshot), FNS 292B (screenshot)	Disaster Relief (Commodities Distrubution) Report of Commodity Distrubution for DR ,   Disaster Relief SNAP Benefit Issuance
Worksheet FNS 388 and 388A OMB# 0081	FNS 388 (SNAP-TERR FNS 388(CNMI-NAP) Remarks.jpg), FNS 388, FNS 388a, FNS 388 (SNAP-TERR - FNS-388 AS.jpg), FNS 388 (SNAP-TERR FNS 388 (PR).jpg)	SNAP Project Area Data Format ,   State Issuance and Participation Estimates ,   State Issuance and Participation Estimates ,   State Issuance and Participation Estimates ,   State Issuance and Participation Estimates
Worksheet FNS 418 OMB# 0280	FNS 418 Worksheet, FNS 418 Worksheet Part (remarks section), FNS 418 Worksheet Part B-D	REPORT OF THE SUMMER FOOD SERVICE PROGRAM FOR CHILDREN ,   REPORT OF THE SUMMER FOOD SERVICE PROGRAM FOR CHILDREN ,   REPORT OF THE SUMMER FOOD SERVICE PROGRAM FOR CHILDREN
Worksheet FNS 44 OMB# 0055	FNS 44, FNS 44, FNS 44	Report of Child and Adult Care Food Program ,   Report of Child and Adult Care Food Program ,   Report of Child and Adult Care Food Program
Worksheet FNS 46 OMB# 0080	FNS 46, FNS 46	Issuance Reconciliation Report ,   Issuance Reconciliation Report (remarks section)
Worksheet FNS 583 OMB# 0339	FNS 583 (screenshot)	SNAP Employment and Training Program Activity Report
Worksheet FNS 648 OMB# 0431	FNS 648 (screenshot 1), FNS 648 (screenshot 2)	WIC Local Agency Directory ,   WIC Local Agency Directory
Worksheet FNS 683 B OMB# 0594	FNS 683 B, FNS 683B (remarks section)	WIC FARMERS' MARKET NUTRITION PROGRAM (FMNP) ANNUAL FINANCIAL AND PROGRAM DATA REPORT ,   WIC FARMERS' MARKET NUTRITION PROGRAM (FMNP) ANNUAL FINANCIAL AND PROGRAM DATA REPORT
Worksheet FNS 683A OMB# 0541	FNS 683a (screenshot 1), FNS-683A (screenshot 2), FNS-683A (screenshot 3)	Senior Farmers' Market Nutrition Program (SFMNP) Annual Financial and Program Data Report ,   Senior Farmers' Market Nutrition Program (SFMNP) Annual Financial and Program Data Report ,   Senior Farmers' Market Nutrition Program (SFMNP) Annual Financial and Program Data Report
Worksheet FNS 759 Revised Instructions for Clarity OMB# 0594 formerly 0542 March 2017	FNS 759 EARS (screenshot 1), FNS 759 EARS (screenshot 2), FNS 759 EARS (screenshot 3)	SNAP Education & Admin Reporting System (EARS) ,   SNAP Education & Admin Reporting System (EARS) ,   SNAP Education & Admin Reporting System (EARS)
Worksheet FNS 777 OMB# 0067	FNS777 (screenshot 2), FNS 777 (screenshot 1), FNS777 (screenshot 7), FNS777 (screenshot 8), FNS777 (screenshot 12), FNS777 (screenshot 3), FNS777 (screenshot 5), FNS777 (screenshot 11), FNS777 (screenshot 14), FNS777 (screenshot 13), FNS777 (screenshot 6), FNS777 (screenshot 4), FNS777 (screenshot 9), FNS777 (screenshot 10)	Financial Status Report ,   Financial Status Report ,   Financial Status Report ,   Financial Status Report ,   Financial Status Report ,   Financial Status Report ,   Financial Status Report ,   Financial Status Report ,   Financial Status Report ,   Financial Status Report ,   Financial Status Report ,   Financial Status Report ,   Financial Status Report ,   Financial Status Report
Worksheet FNS 778 AND 778A OMB# 0584-0594	FNS 778 & 778a (screenshot1), FNS 778 & 778a (screenshot4), FNS 778 & 778a (screenshot5), FNS 778 & 778a (screenshot2), FNS 778 & 778A (screenshot3), FNS 778 & 778a (screenshot6)	Federal Financial Report (SNAP OPERATIONS) ,   Federal Financial Report (SNAP OPERATIONS) ,   Federal Financial Report (SNAP OPERATIONS) ,   Federal Financial Report (SNAP OPERATIONS) ,   Federal Financial Report (SNAP OPERATIONS) ,   Federal Financial Report (SNAP OPERATIONS)
Worksheet FNS 798 and 798A OMB# 0045	FNS 798/798A (screenshot 1), FNS798/798A (screenshot 2), FNS 798/798A (screenshot 7), FNS 798/798A (screenshot 8), FNS 798/798A (screenshot 6), FNS 789/798A (screenshot 2), FNS 798-798A (screenshot 4), FNS 798/798A (screenshot 5)	WIC Financial Management and Participation Report ,   WIC Financial Management and Participation Report ,   WIC Financial Management and Participation Report ,   WIC Financial Management and Participation Report ,   WIC Financial Management and Participation Report ,   WIC Financial Management and Participation Report ,   WIC Financial Management and Participation Report ,   WIC Financial Management and Participation Report

---

ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	47,157	46,378	0	832	-53	0
Annual Time Burden (Hours)	102,044	104,749	0	2,092	-4,797	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Changing Forms

Short Statement: The requested burden hours (104,610.50 total annual burden hours and 36,868.00 total annual responses) associated with this collection and the cost to respondents are shown in the attached chart. In addition, there are an estimated 12,708 respondents for this collection. Time estimates include the time needed to gather, compile and record data and submit it to FNS using FPRS. There is no recordkeeping burden associated with this data collection. All other reporting burden hours associated with these worksheets/data elements on the parallel worksheets has been discontinued and there is no duplicative burden associated with them. However, there is duplicative burden contained in two information collections, OMB# 0584-0608 SNAP Requirement for National Directory of New Hires Employment Verification and Annual Program Activity and OMB# 0584-0293 Food Distribution Program that is associated with forms in this collection. FNS is working on removing this duplicate burden as from these collections. Nonetheless, there may still be other reporting activities not captured on these worksheets/forms. Therefore, there may be reporting burden remaining in those OMB control numbers and there is a high probability of recordkeeping burden involved with many of the existing FNS forms/worksheets identified in this request. Any other reporting burden activities (not reported on the FPRS worksheets) and recordkeeping burden hours will remain with those existing collections. Lastly, recordkeeping for the SF 425 will be contained in OMB Control # 0584-0512, expiration date: 7/31/2022 the FNS Discretionary Grant generic request.

---

Annual Cost to Federal Government: $12,265,428

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 09/30/2019

---