Sf 425 Fns 778 Federal Financial Report Snap-op

Operating Guidelines, Forms, Waivers, and Annual State Report on Verification of SNAP Participation

Appendix F SF-425_778

OMB: 0584-0083

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OMB Control Number 0584-0083
Expiration Date: xx/xx/xxxx

Appendix F: SF 425/FNS 778
FEDERAL FINANCIAL REPORT
SNAP-OP

(Follow form instructions)
2. Federal Grant or Other Identifying Number Assigned by Federal Agency

1. Federal Agency and Organizational Element
to Which Report is Submitted
FOOD AND NUTRITION SERVICE, USDA
3. Recipient Organization (Name and complete address including Zip code)
4a. DUNS Number

4b. EIN

5. Recipient Account Number or Identifying Number

8. Project/Grant Period

Page
1

6. Report Type
_ Quarterly
__ Final

of
1
pages

7. Basis of Accounting
__ Cash __ Accrual

9. Reporting Period End Date

10. Transactions
(Use lines a-c for single or multiple grant reporting)
Federal Cash:
a. Cash Receipts
b. Cash Disbursements
c. Cash on Hand (line a minus b)
(Use lines d-o for single grant reporting)
Federal Expenditures and Unobligated Balance:
d. Total Federal funds authorized
e. Federal share of expenditures
f. Federal share of unliquidated obligations
g. Total Federal share (sum of lines e and f)
h. Unobligated balance of Federal funds (line d minus g)
Recipient Share:
i. Total recipient share required
j. Recipient share of expenditures
k. Remaining recipient share to be provided (line i minus j)
Program Income:
l. Total Federal program income earned
m. Program income expended in accordance with the deduction alternative
n. Program income expended in accordance with the addition alternative
o. Unexpended program income (line l minus line m or line n)
c. Period From
b. Rate
a. Type
11. Indirect
Expense

Cumulative

Period To

d. Base

e. Amount Charged

f. Federal Share

g. Totals:
12. Remarks: Attach any explanations deemed necessary or information required by Federal sponsoring agency in compliance with governing legislation:
See corresponding FNS-778/778A for detailed information. [Insert text copied from FNS-778/778A remarks section]
13. Certification: By signing this report, I certify that it is true, complete, and accurate to the best of my knowledge. I am aware that any false, fictitious, or fraudulent information may subject me to criminal,
civil, or administrative penalties. (U.S. Code, Title 18, Section 1001)

a. Typed or Printed Name and Title of Authorized Certifying Official

c. Telephone (Area code, number and extension)
d. Email address

b. Signature of Authorized Certifying Official
STAMP/CERTIFY DATE
Printed on 07/26/2011 03:17:07 PM
FPRS Electronic Version

LAST UPDATED BY

e. Date Report Submitted (Month, Day, Year)
LAST UPDATED ON

14. Agency use only:
Standard Form 425
OMB Approval Number: 0348-0061
Expiration Date: 10/31/2011

Paperwork Burden Statement
According to the Paperwork Reduction Act, as amended, no persons are required to respond to a collection of information unless it displays a valid OMB Control Number. The valid OMB control number for this information collection is 03480061. Public reporting burden for this collection of information is estimated to average 1.5 hours per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget
Paperwork Reduction Project ( 0348-0060), Washington, DC 20503.

FNS-778/778A SNAP Worksheet for the SF-425

FEDERAL GRANT OR OTHER
NUMBER

1. FEDERAL AGENCY & ORGANIZATIONAL ELEMENT TO WHICH REPORT IS SUBMITTED

FINANCIAL STATUS REPORT

Letter of Credit
No. 12-35-

FOOD AND NUTRITION SERVICE, USDA
3. STATE AGENCY (Name and complete address, including
ZIP code. Also enter assigned State code.)

4. AGENCY DUNS NUMBER

5. STATE AGENCY ACCOUNT OR ID NO.

6. FINAL REPORT

7. BASIS

___ YES
8. PROJECT/GRANT PERIOD

10. STATUS OF FUNDS
SNAP FUNCTIONS/ACTIVITIES

2a. FISCAL YEAR

___CASH

___ ACCRUAL

9. PERIOD COVERED BY THIS REPORT

SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM
1

CERTIFICATION

EBT
ISSUANCE

QUAL. CNTL.

MGT.EVAL.

FRAUD CNTL.

ADP. DEV.

ADP OPER

FAIR
HEARINGS

OTHER ACTIVITIES SUB. TOT. 20+30

GRAND TOTAL

a. Net outlays previously reported
b. Total outlays this report period
c. Less: Program Income credits
d. Net outlays this report period
(Line b minus line c)
e. Net outlays to date
(Line a plus line d)
f. Less: Non-Federal share of outlays
g. Total Federal share of outlays
(Line e minus line f)
h. Total unliquidated obligations
i. Less: Non-Federal share of unliquidated
obligations shown on line h
j. Federal share of unliquidated obligations
k Total Federal share of outlays
k.
and unliquidated obligations
l. Total cumulative amount of Federal
funds authorized
m. Unobligated balance of Federal funds
11. INDIRECT

a. TYPE OF RATE
___PROVISIONAL

EXPENSE

b. RATE

___ PREDETERMINED

___ FINAL

c. BASE

13. CERTIFICATION

___ FIXED

d. TOTAL AMOUNT

LAST UPDATED BY

No further monies or other benefits may be paid out under this program unless this
report is completed and filed as required be existing regulation (34 C.F.R 256)
FPRS Electronic Version

DATE REPORT SUBMITTED

e. FEDERAL SHARE

12. REMARKS: Attach any explanation deemed necessary or information required by Federal sponsoring agency in
compliance with governing legislation.
STAMP/CERTIFY DATE

SIGNATURE OF AUTHORIZED CERTIFYING
OFFICIAL

LAST UPDATED ON

I certify to the best of my knowledge and belief that
this report is correct and complete and that all outlays
and unliquidated obligations are for the purposes set
forth in the award documents.
NAME

TITLE

TELEPHONE NO.
AREA CODE NUMBER
FNS-778 (10-08)
Page 1 of 4

FNS-778/778A SNAP Worksheet for the SF-425

FEDERAL GRANT OR OTHER
NUMBER

1. FEDERAL AGENCY & ORGANIZATIONAL ELEMENT TO WHICH REPORT IS SUBMITTED

FINANCIAL STATUS REPORT

Letter of Credit
No. 12-35-

FOOD AND NUTRITION SERVICE, USDA
3. STATE AGENCY (Name and complete address, including
ZIP code. Also enter assigned State code.)

4. AGENCY DUNS NUMBER

5. STATE AGENCY ACCOUNT OR ID NO.

6. FINAL REPORT

7. BASIS

___ YES
8. PROJECT/GRANT PERIOD

10. STATUS OF FUNDS

2a. FISCAL YEAR

___CASH

___ ACCRUAL

9. PERIOD COVERED BY THIS REPORT

SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM

SNAP FUNCTIONS/ACTIVITIES

E&T
100% GRANT

E&T
50% GRANT

E&T
DEPENDENT CARE

E&T
TRANS. & OTHER

E&T
ABAWD GRANT

OPTIONAL
WORKFARE

OUTREACH

NUTRITION
EDUCATION

NEW
INVESTMENT

PAGE 2
SUBTOTAL

a. TYPE OF RATE
___PROVISIONAL

EXPENSE

b. RATE

___ PREDETERMINED

___ FINAL

c. BASE

13. CERTIFICATION

___ FIXED

d. TOTAL AMOUNT

LAST UPDATED BY

No further monies or other benefits may be paid out under this program unless this
report is completed and filed as required be existing regulation (34 C.F.R 256)
FPRS Electronic Version

DATE REPORT SUBMITTED

e. FEDERAL SHARE

12. REMARKS: Attach any explanation deemed necessary or information required by Federal sponsoring agency in
compliance with governing legislation.
STAMP/CERTIFY DATE

SIGNATURE OF AUTHORIZED CERTIFYING
OFFICIAL

LAST UPDATED ON

I certify to the best of my knowledge and belief that
this report is correct and complete and that all outlays
and unliquidated obligations are for the purposes set
forth in the award documents.
NAME

TITLE

TELEPHONE NO.
AREA CODE NUMBER
FNS-778 (10-08)
Page 2 of 4

FNS-778/778A SNAP Worksheet for the SF-425

FEDERAL GRANT OR OTHER
NUMBER

1. FEDERAL AGENCY & ORGANIZATIONAL ELEMENT TO WHICH REPORT IS SUBMITTED

FINANCIAL STATUS REPORT

Letter of Credit
No. 12-35-

FOOD AND NUTRITION SERVICE, USDA
3. STATE AGENCY (Name and complete address, including
ZIP code. Also enter assigned State code.)

4. AGENCY DUNS NUMBER

5. STATE AGENCY ACCOUNT OR ID NO.

6. FINAL REPORT
___ YES

8. PROJECT/GRANT PERIOD

10. STATUS OF FUNDS

2a. FISCAL YEAR

7. BASIS
_ NO

___CASH

___ ACCRUAL

9. PERIOD COVERED BY THIS REPORT

SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM

SNAP FUNCTIONS/ACTIVITIES

ISSUANCE
INDIRECT

EBT
STARTUP

SAVE

100%
STATE EXCHANGE

75% INDIAN
ADMINISTRATION

50% UNSPECIFIED
OTHER

30
PAGE 3
SUBTOTAL

a. TYPE OF RATE
___PROVISIONAL

EXPENSE

b. RATE

___ PREDETERMINED

___ FINAL

c. BASE

13. CERTIFICATION

___ FIXED

d. TOTAL AMOUNT

LAST UPDATED BY

No further monies or other benefits may be paid out under this program unless this
report is completed and filed as required be existing regulation (34 C.F.R 256)
FPRS Electronic Version

DATE REPORT SUBMITTED

e. FEDERAL SHARE

12. REMARKS: Attach any explanation deemed necessary or information required by Federal sponsoring agency in
compliance with governing legislation.
STAMP/CERTIFY DATE

SIGNATURE OF AUTHORIZED CERTIFYING
OFFICIAL

LAST UPDATED ON

I certify to the best of my knowledge and belief that
this report is correct and complete and that all outlays
and unliquidated obligations are for the purposes set
forth in the award documents.
NAME

TITLE

TELEPHONE NO.
AREA CODE NUMBER
FNS-778 (10-08)
Page 3 of 4

FNS-778/778A SNAP Worksheet for the SF-425

1. FEDERAL AGENCY & ORGANIZATIONAL ELEMENT TO WHICH REPORT IS SUBMITTED

2.FEDERAL GRANT OR OTHER
NUMBER

FINANCIAL STATUS REPORT

Letter of Credit
No. 12-35-

FOOD AND NUTRITION SERVICE, USDA
3. STATE AGENCY (Name and complete address, including
ZIP code. Also enter assigned State code.)

4. AGENCY DUNS NUMBER

5. STATE AGENCY ACCOUNT OR ID NO.

6. FINAL REPORT
___ YES

8. PROJECT/GRANT PERIOD

10. STATUS OF FUNDS

2a. FISCAL YEAR

7. BASIS
_ NO

___CASH
___ ACCRUAL
9. PERIOD COVERED BY THIS REPORT

SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM
31

SNAP FUNCTIONS/ACTIVITIES

PROGRAM
BENEFITS

a. Net outlays previously reported
b. Total outlays this report period
c. Less: Program Income credits
d. Net outlays this report period
(Line b minus line c)
e. Net outlays to date
(Line a plus line d)
f. Less: Non-Federal share of outlays
g. Total Federal share of outlays
(Line e minus line f)
h. Total unliquidated obligations
i. Less: Non-Federal share of unliquidated
obligations shown on line h
j. Federal share of unliquidated obligations
k. Total Federal share of outlays
and unliquidated obligations
l. Total cumulative amount of Federal
funds authorized
m. Unobligated balance of Federal funds
11. INDIRECT

a. TYPE OF RATE
PROVISIONAL

EXPENSE

b. RATE

PREDETERMINED
c. BASE

FINAL
FIXED
d. TOTAL AMOUNT

13. CERTIFICATION

SIGNATURE OF AUTHORIZED CERTIFYING
OFFICIAL

DATE REPORT SUBMITTED

e. FEDERAL SHARE

12. REMARKS: Attach any explanation deemed necessary or information required by Federal sponsoring agency in
compliance with governing legislation.
LAST UPDATED ON
STAMP/CERTIFY DATE
LAST UPDATED BY

I certify to the best of my knowledge and belief that
this report is correct and complete and that all outlays
and unliquidated obligations are for the purposes set
forth in the award documents.
NAME

TITLE

TELEPHONE NO.
AREA CODE

No further monies or other benefits may be paid out under this program unless this
report is completed and filed as required be existing regulation (34 C.F.R 256)
FPRS Electronic Version

NUMBER

Form FNS-778A (10-08)
Page 4 of 4

FNS-778/778A SNAP Worksheet for the SF-425

INSTRUCTIONS
The FNS‐778 is used to report State administrative costs for the Supplemental Nutrition Assistance Program (SNAP). NOTE:
Program benefits are reported on the FNS‐778A. DO NOT include program benefits in Columns 1 ‐ 30 on the FNS‐778.
Please type or print legibly. Items 1, 2, 3, 6, 7, 9, 10d, 10e, 10g, 10i, 10l, 11a, and 12 are self‐explanatory; specific instructions
for other items as follows:
Item Entry
4. Enter the State agency's Universal Identifier (DUNS) Number.
5. This space is reserved for an account number or other identifying numbers that may be assigned by the State agency.
8. Enter the month, day, and year of the beginning and ending of this grant period.
10. The purpose of vertical columns (1) through (30) is to provide financial data for each function and activity in the budget as
approved by FNS.
10a. Enter the amount reported in Line 10e of the last report. If there has been an adjustment to the amount shown
previously, please attach an explanation or explain in the Remarks block. Show zero if this is the initial report.
10b. Enter the total gross program outlays (less rebates, refunds, and other discounts) for this report period, including
disbursements of cash realized as program income. For reports that are prepared on a cash basis, outlays are the sum of actual
cash disbursements for goods and services, the amount of indirect expense charged, the value of in‐kind contributions applied,
and the amount of cash advances and payments made to contractors and subgrantees. For reports prepared on an accrual
basis, outlays are the sum of actual cash disbursements, the amount of indirect expense incurred, the value of in‐kind
contributions applied, and the net increase (or decrease) in the amounts owed by the State agency for goods and other
property received and for services performed by employees, contractors, subgrantees, and other payees.
10c. Enter the amount of all program income realized in this reporting period that is required by Program regulations to be
deducted from total program costs. For reports prepared on a cash basis, enter the amount of cash income received during the
reporting period. For reports prepared on an accrual basis, enter the amount of income earned since the beginning of this
reporting period. When Program regulations allow program income to be added to the total award, explain in remarks, the
source, amount and disposition of the income.
10f. Enter amount pertaining to the non‐Federal share of program outlays included in the amount on line e.
10h. Enter total amount of unliquidated obligations for the Supplemental Nutrition Assistance Program (SNAP). Included in
unliquidated obligations are: Cash basis ‐ obligations incurred but not paid. Accrual basis ‐ obligations incurred but for which an
outlay has not been recorded. Do not include any amounts that have been included on lines a through g. On the final report,
line h should have a zero balance.
10j. Enter the Federal share of unliquidated obligations shown on line h. The amount shown on this line should be the
difference between the amounts on lines h and i.
10k. Enter the sum of the amounts shown on lines g and j. If the report is final, the report should not contain any unliquidated
obligations.

10m. Enter the unobligated balance of Federal funds. This amount should be difference between lines k and l.
11b. Enter rate in effect during the reporting period.
11c. Enter amount of the base to which the rate was applied.
11d. Enter total amount of indirect cost charged during the report period.
11e. Enter the Federal share of the amount entered in item 11d.
If more than one rate was applied during the grant period, enter in the remarks block on pages 2 and 3 (or include in a separate
schedule) information showing bases against which the indirect cost rates were applied, the respective indirect rates, the
month, day, and year the indirect rates were in effect, amounts of indirect expense charged to the program, and the Federal
share of indirect expense charged to the program to date.
NOTE: Each column represents that portion of total outlays and/or obligations based on Direct Costs and allocated Indirect
Costs. Indirect issuance costs assigned by cost rates are reported in “Issuance Indirect” (Column 21).
1. CERTIFICATION: Enter the costs for certification activity, including accepting and processing the application. Include salaries,
benefits, travel expenses, supervisory, clerical, and other support costs.
2. ELECTRONIC BENEFIT TRANSFER (EBT) ISSUANCE: Enter the costs for EBT issuance. Include all EBT operational costs and EBT
equipment costs. Include Direct Costs and Indirect Costs charged through a public assistance cost allocation plan (PACAP). Do
not include indirect EBT issuance costs charged through an indirect cost rate. (These are reported in Column 21.).
3. QUALITY CONTROL: Enter the costs for Quality Control activity, including travel expenses.
4. MANAGEMENT EVALUATION: Enter the costs for Management Evaluation activities.
5. FRAUD CONTROL: Enter the costs for qualified employees engaged specifically in the investigation and prosecution of SNAP
fraud activity.
6. ADP DEVELOPMENT: Enter the computer system development costs which are to be reimbursed at the Federal Financial
Participation rate of 50%. Include EBT planning costs which are to be reimbursed at the Federal Financial Participation rate of
50%
7. ADP OPERATIONS: Enter the operational costs of computer systems which are charges under an approved cost allocation
plan.
8. FAIR HEARINGS: Enter the costs for Fair Hearing activities
9. OTHER COSTS: Enter the sum of Columns 20 and 30, These columns respectively capture the sums of Columns 11 ‐ 19 (page
2) and 21 ‐ 24 (page 3) of this form. They thereby capture the costs for all other SNAP activities, including the E&T function,
Outreach, Nutrition Education, reinvestment, SAVE, etc..
10. GRAND TOTAL: Enter the total administrative costs for the SNAP. This is the sum of Columns 1 through 9.
11. EMPLOYMENT AND TRAINING (E&T) PROGRAM GRANT ALLOCATION (100% GRANT): Enter the amount of the unmatched
Federal grant expended on administrative costs of the E&T program. NOTE: If applicable, do not include amount from Column
15: E&T ABAWD GRANT in this category. Do not include participant reimbursements in this category.
12. E&T ADMINISTRATIVE COSTS (50% MATCHING): Enter the amount in excess of the E&T allocation (Column 11 ) and, if
applicable, the additional E&T allocation for “pledge” States (Column 15), expended to operate the E&T program in accordance
with the FNS‐approved State E&T plan. Do not include participant reimbursements in this category.

13. E&T PARTICIPANT REIMBURSEMENT ‐ DEPENDENT CARE: Enter the amount expended to reimburse E&T participants for the
costs of dependent care incurred as a result of E&T participation. NOTE: The Federal contribution may not exceed one‐half of
the lesser amount of either the actual cost of dependent care or the applicable payment rate for child care established in
accordance with the Child Care and Development Block Grant provisions of 45 CFR 98.43.
14. E&T PARTICIPANT REIMBURSEMENT ‐ TRANSPORTATION AND OTHER COSTS: Enter the amount expended to reimburse E&T
participants for the costs of transportation and other reasonable and necessary costs (other than dependent care) incurred as a
result of E&T participation.
15. E&T ABAWD GRANT: Enter the amount of the unmatched additional Federal grant allocated under section 16 (h)(1)(E) of the
Act expended to provide qualifying education/training or workfare opportunities to applicants and recipients subject to the 3‐
month SNAP time limit for able‐bodied adults without dependents. NOTE: This amount is separate from ‐ and must not be
included as part of ‐ 100 percent Federal E&T grant expenditures in Column 11.
16. OPTIONAL WORKFARE: Enter the operational costs for workfare programs operated under Section 20 of the Act. These are
only programs which are not included in Employment and Training Programs. Include the cost when the participant has been
reimbursed for workfare‐related expenses such as transportation, child care, or the cost for personal safety items or equipment
required for performance of work if these items are also purchased by regular employees. (Do not include enhanced
reimbursement which should be reported on the SF‐270.)
17. OUTREACH: Enter the outreach costs. Include as outreach costs only those costs which were included in the FNS approved
plan for Program informational activities.
18. NUTRITION EDUCATION: Enter the nutrition education costs. Enter as nutrition education costs only those costs which were
included in the FNS approved plan for Nutrition Education
19. NEW INVESTMENT: Enter those costs which were funded in full by the State agency in accordance with the State agency's
FNS approved plan without any Federal matching funds.
20. PAGE 2 SUBTOTAL: Enter sum of items identified and recorded in columns 11‐19. The total in Column 20 must be included in
Column 9.
21. ISSUANCE INDIRECT: Enter the indirect costs for EBT issuance systems that are approved for cost charging through an
indirect cost rate.
22. EBT START‐UP: Enter the EBT system start‐up costs incurred after the Implementation Advance Planning Document (IAPD) is
approved and prior to issuance of benefits by the EBT system. Start‐up costs include design, development, and implementation
costs. They do NOT include system planning approved by FNS; all EBT planning costs prior to approval of the IAPD should be
reported in Column 6 (ADP Development.)
23. SYSTEMATIC ALIEN VERIFICATION FOR ENTITLEMENTS (SAVE): Enter the administrative costs of planning, implementing and
operating a SAVE system.
24. 100% STATE EXCHANGE: Enter the travel costs and costs for printed materials and electronic or other media related to the
exchange of ideas and experience for improving program management among States that are approved by FNS and reimbursed
with 100% State Exchange funds.
25. 75% INDIAN ADMINISTRATION: Enter the costs incurred to administer the program on an Indian reservation and that will be
claimed at the 75% enhanced reimbursement rate for this activity.
26. 50% UNSPECIFIED OTHER: Enter that portion of Column 9, "Other Activities," not specifically identified and recorded in
column 11‐19 and 21‐25. Include Wage Matching, etc.
30. PAGE 3 SUBTOTAL: Enter the total of Columns 21 through 26. The total from Column 30 must be included in Column 9.
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a Collection of Information unless it displays
a valid OMB control number. The valid OMB number is 0584‐XXXX. The time required to complete this information collection is
estimated to average 16.8 hours per response, including the time to review the instructions, search data sources, gather the data
needed, and complete and review the information collection.

File Type	application/pdf
File Title	425_778_778A_Mockup_2.xlsx
Author	ewatland
File Modified	2023-07-17
File Created	2011-09-06