Ams-71

AMS-71 DDP UPDATED.xlsx

Dairy Donation Program

AMS-71

OMB: 0581-0327

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INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.
TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.
Dairy Donation and Distribution Plan, Eligible Distributor Certification Form, Reimbursement Claim Form, and Report of Receipts and Utilization 0581-0327


DATE PREPARED
March 9, 2022
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT
ANNUAL BURDEN








REPORTS RECORDS





















TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-
SECTION OF DESCRIPTION (If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS
REGS.




so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)








RESPONDENT



KEEPER
(A) (B) (C) (D) (E) (F) (G) (H) (I) (J) (K)
7 CFR 1147.102 Dairy Donation and Distribution Plan DDP-P 150 2 300.00 1.0000 300

0.00
7 CFR 1147.102 Eligible Distributor Certification Form DDP-C 300 1 300.00 0.2500 75

0.00
7 CFR 1147.106 Reimbursement Claim Form DDP-RC 150 8 1,200.00 2.0000 2,400

0.00
7 CFR 1147.1 Report of Receipts and Utilization (currently approved under OMB-0581-0032) HR-EZ 15 1 15.00 1.0000 15

0.00











































0.00

TOTAL
615.00 12.00 1,815.00 4.25 2,790.00

0.00
File Typeapplication/vnd.openxmlformats-officedocument.spreadsheetml.sheet
File Modified0000-00-00
File Created0000-00-00

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