State Agencies

Child and Adult Care Food Program (CACFP) National Disqualified List

OMB: 0584-0584

IC ID: 206841

Information Collection (IC) Details

View Information Collection (IC)

State Agencies
 
No Modified
 
Mandatory
 
7 CFR 226.6(c)(7)(i)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form FNS-843 Report of Disqualification from Participation - Institution and Responsible Principals/Individuals Attachment A-1 FNS-843.pdf www.usda.gov Yes Yes Fillable Fileable
Form FNS-844 Report of Disqualification from Participation - Individually Disqualified Responsible Principal/Individual or Day Care Home Provider Attachment A-2 FNS-844.pdf Yes Yes Fillable Fileable

Income Security Food and Nutrition Assistance

USDA/FNS-11 Information on Persons Identified as Responsible for Serious Deficiencies, Proposed for Disqualification, or Disqualified to Participate as Principals or Family Day Care Home Operators in   69 FR 6933

56 0
   
State, Local, and Tribal Governments
 
   100 %

  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 1,568 0 0 0 0 1,568
Annual IC Time Burden (Hours) 784 0 0 0 0 784
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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