Information Collection

Fns 640

IC 223716 under ICR 202204-0584-003 · OMB 0584-0594.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0594 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FNS 640 (A/B) (scr FNS 640	Form and Instruction
FNS-640 sheet A.pdf	Instruction
FNS-640 sheet A.pdf	Instruction
FNS-640 sheet B.pdf	Instruction
FNS-640 sheet B.pdf	Instruction
FNS 640 (A/B) (scr Administrative Review Report CN FNS-640.jpg www.fprs.gov	Form and Instruction
FNS 640 (A/B) (scr Administrative Review Report CN FNS-640.jpg www.fprs.gov	Form and Instruction
FNS 640 (A/B) (scr Administrative Review Report CN FNS-640 Errors.jpg	Form and Instruction
FNS 640 (A/B) (scr Administrative Review Report CN FNS-640 Errors.jpg	Form and Instruction
FNS-640 (A/B) (scr Administrative Review Report CN FNS-640 Warnings.jpg	Form and Instruction
FNS-640 (A/B) (scr Administrative Review Report CN FNS-640 Warnings.jpg	Form and Instruction

IC Title:

FNS 640

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FNS 640 (A/B) (screenshot1)	Administrative Review Report	CN FNS-640.jpg	www.fprs.gov	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FNS 640 (A/B) (screenshot2)	Administrative Review Report	CN FNS-640 Errors.jpg		Yes	Yes	Fillable Fileable Signable
Form and Instruction	FNS-640 (A/B) (screenshot3)	Administrative Review Report	CN FNS-640 Warnings.jpg		Yes	Yes	Fillable Fileable Signable
Instruction			FNS-640 sheet A.pdf		Yes	Yes	Fillable Fileable Signable
Instruction			FNS-640 sheet B.pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 56

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	56	56
Annual IC Time Burden (Hours)	280	280
Annual IC Cost Burden (Dollars)	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.