Information Collection

Dairy Donation Program

IC 247737 under ICR 202203-0581-002 · OMB 0581-0327.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DDP-P Dairy Donation Program	Form and Instruction
DDP-P Dairy Donation and Distribution Plan Dairy Donation and Distribution Plan Form.xlsx	Form and Instruction
DDP-C Eligible Distributor Certification Form Eligible Distributor Certification Form.xlsx	Form and Instruction
DDP-RC Reimbursement Claim Form Reimbursement Claim Form.xlsx	Form and Instruction
HR-EZ Reimbursement Claim Form Report of Receipts and Utilization.xls	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	DDP-P	Dairy Donation and Distribution Plan	Dairy Donation and Distribution Plan Form.xlsx	Yes	No	Fillable Printable
Form and Instruction	DDP-C	Eligible Distributor Certification Form	Eligible Distributor Certification Form.xlsx	Yes	No	Fillable Printable
Form and Instruction	DDP-RC	Reimbursement Claim Form	Reimbursement Claim Form.xlsx	Yes	No	Fillable Printable
Form and Instruction	HR-EZ	Reimbursement Claim Form	Report of Receipts and Utilization.xls	Yes	No	Fillable Printable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 615

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,815	-75	1,890
Annual IC Time Burden (Hours)	2,790	-75	2,865
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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