State and Local Burden

7 CFR Part 210 National School Lunch Program

OMB: 0584-0006

IC ID: 2879

Documents and Forms
Document Name
Document Type
Other-Attachment T1: Off-site Assess
Other-Attachment T2: On-site Assessm
Other-Attachment T3: Site Selection
Other-Attachment T4: Statistical Sam
Other-Attachment T5: Meal Compliance
Other-Attachment T6: Dietary Specifi
Other-Attachment T7: Nutrient Analys
Other-Attachment T8: Nutrient Analys
Other-Attachment T9: Resource Manage
Other-Attachment T10: Resource Manag
Other-Attachment T11: Fiscal Action
Other-Attachment T12: Non-reimbursab
Other-Attachment T13: School Data an
Other-Attachment T14: Other Meal Cla
Other-Attachment T15: Eligibility Ce
Other-Attachment T16: Other Eligibil
Other-Attachment T17: SFA Data Summa
Other-Attachment T18: Special Provis
Other-Attachment T19: Community Elig
Other-Attachment T20: Seamless Summe
Other-Attachment T21: Seamless Summe
Other-Attachment T22: Supplemental S
Other-Attachment T23: Supplemental A
Other-Attachment T24: Supplemental S
Other-Attachment T25: Infant and Pre
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

State and Local Burden
 
No Modified
 
Required to Obtain or Retain Benefits
 
7 CFR 210.31(d)(2),(3) 7 CFR 210.11(b)(2) 7 CFR 210.5(d)(2)(ii) 7 CFR 210.9(b)(21),(c)(7) 7 CFR 210.18(m)(1) 7 CFR 210.31e(2),e(3) 7 CFR 210 7 CFR 210.11(b)(2) 7 CFR 210.15(a)(7) 7 CFR 210.5(d)(2)(ii) 7 CFR 210.18(i)(3) 7 CFR 210.18(c-h) 7 CFR 210.13(b) 7 CFR 210.18(h)(2)(iv) 7 CFR 210.9(b)(19) 7 CFR 210.31(a)&(c)(5) 7 CFR 210.20(b)(11),(b)(14) 7 CFR 210.10(m) 7 CFR 210.19(f) 7 CFR 210.20(a)(7) 7 CFR 210.15(a)(1) &210.8(b)&(c) 7 CFR 210.15(b)(1)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Attachment T10: Resource Management Risk Indicator Tool Attachment T10. Resource Management Risk Indicator Tool.pdf No   Paper Only
Other-Attachment T18: Special Provisions Non-Base Year and CEP Claiming Percentage/Funding Level Summary Form (SFA-1A) Attachment T18. Special Provisions Non-Base Year and CEP Claiming Percentage Funding Level Summary Form SFA-1A.pdf No   Paper Only
Other-Attachment T23: Supplemental Afterschool Snacks Administrative Review Form Attachment T23. Supplemental Afterschool Snacks Administrative Review Form.pdf No   Paper Only
Other-Attachment T19: Community Eligibility Provison ISP and Claiming Percentage Validation Worksheet (SFA-2A) Attachment T19. Community Eligibility Provision ISP and Claiming Percentage Validation Worksheet (SFA-2A).pdf No   Paper Only
Other-Attachment T22: Supplemental Seamless Summer Option Administrative Review Form Attachment T22. Supplemental Seamless Summer Option Administrative Review Form.pdf No   Paper Only
Other-Attachment T24: Supplemental Special Milk Program Administrative Review Form Attachment T24. Supplemental Special Milk Program Administrative Review Form.pdf No   Paper Only
Other-Attachment T25: Infant and Pre-K Meal Pattern On-Site Validation Checklist Attachment T25. Infant and Pre-K Meal Pattern On-Site Validation Checklist.pdf No   Paper Only
Other-Attachment T2: On-site Assessment Tool Attachment T2. On-site Assessment Tool.pdf No   Paper Only
Other-Attachment T12: Non-reimbursable Meal Allocation Form Attachment T12. Non-reimbursable Meal Allocation Form.pdf No   Paper Only
Other-Attachment T13: School Data and Meal Pattern Error Form (S-1) Attachment T13. School Data and Meal Pattern Error Form (S-1).pdf No   Paper Only
Other-Attachment T5: Meal Compliance Risk Assessment Tool Attachment T5. Meal Compliance Risk Assessment Tool.pdf No   Paper Only
Other-Attachment T17: SFA Data Summary Form (SFA-3) Attachment T17. SFA Data Summary Form (SFA-3).pdf No   Paper Only
Other-Attachment T3: Site Selection Worksheet Attachment T3. Site Selection Worksheet.pdf No   Paper Only
Other-Attachment T4: Statistical Sample Generator Attachment T4.Statistical Sample Generator.pdf No   Paper Only
Other-Attachment T9: Resource Management Comprehensive Review Form Attachment T9. Resource Management Comprehensive Review Form.pdf No   Paper Only
Other-Attachment T16: Other Eligibility Certifcation and Benefit Issuance Errors Worksheet (SFA-2) Attachment T16. Other Eligibility Certification and Benefit Issuance Errors Worksheet (SFA-2).pdf No   Paper Only
Other-Attachment T21: Seamless Summer Option Eligibility Certification Form (SSO S-2) Attachment T21. Seamless Summer Option Eligibility Certification Form (SSO S-2).pdf No   Paper Only
Other-Attachment T1: Off-site Assessment Tool Attachment T1. Off-site Assessment Tool.pdf No   Paper Only
Other-Attachment T6: Dietary Specifications Assessment Tool Attachment T6. Dietary Specifications Assessment Tool.pdf No   Paper Only
Other-Attachment T15: Eligibility Certification and Benefit Issuance Error Worksheet (SFA-1) Attachment T15. Eligibility and Certification and Benefit Issuance Error Worksheet.pdf No   Paper Only
Other-Attachment T11: Fiscal Action Workbook Attachment T11. Fiscal Action Workbook.xlsx No   Paper Only
Other-Attachment T14: Other Meal Claim Errors (S-2) Attachment T14. Other Meal Claim Errors (S-2).pdf No   Paper Only
Other-Attachment T7: Nutrient Analysis and Validation Checklist Attachment T7. Nutrient Analysis and Validation Checklist.pdf No   Paper Only
Other-Attachment T8: Nutrient Analysis Protocols Attachment T8. Nutrient Analysis Protocols.pdf No   Paper Only
Other-Attachment T20: Seamless Summer Option School Data and Meal Pattern Error Form (SSO S-1) Attachment T20. Seamless Summer Option School Data and Meal Pattern Error Form (SSO S-1).pdf No   Paper Only

Income Security Food and Nutrition Assistance

 

115,935 115,499
   
State, Local, and Tribal Governments
 
   96 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 47,631,996 0 12,918 -2,203,327 0 49,822,405
Annual IC Time Burden (Hours) 9,808,454 0 304,711 -526,257 0 10,030,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Attachment C: Form FNS-640 Administrative Review Data Report Attachment C. Form FNS-640 Administrative Review Data Report.pdf 09/29/2019
Attachment D: OMB# 0584-0594 Food Programs Reporting System (FPRS) Home Screen with OMB Information and Public Burden Statement Attachment D. FPRS Home Screen.pdf 09/29/2019
Attachment E: Form FNS-10 Report of School Operations (OMB# 0584-0594) Attachment E. FNS-10 Report of School Operations.pdf 09/29/2019
Attachment F: Form FNS-13 Annual Report of State Revenue Matching (OMB# 0584-0594) Attachment F. FNS-13 Annual Report of State Revenue Matching.pdf 09/29/2019
Attachment G: Form FNS-828 School Food Authority Paid Lunch Price Report (OMB# 0584-0594) Attachment G. FNS-828 School Food Authority Paid Lunch Price Report.pdf 09/29/2019
Attachment H: Form FNS-777 Financial Status Report (OMB# 0584-0594) Attachment H. FNS-777 Financial Status Report.pdf 09/29/2019
Attachment T: Administrative Review Manual Attachment T. Administrative Review Guidance Manual 2018_2019.pdf 11/05/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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