| Respondent Category |
Instruments |
Form |
Number of respondents |
Frequency of response |
Total Annual responses |
Responses per Respondent |
Hours per response |
Annual burden (hours) |
Previously Approved Annual Burden Hours |
Difference due to Program Change |
Difference due to Adjustment |
Hourly Wage Rate |
Fully Loaded ( Hourly wage + 33%) |
Total Annualized Cost of Respondent Burden |
| Individuals / Households |
P-EBT Application Submission (Schools Only) |
N/A |
114,000 |
1 |
114,000 |
1 |
0.166666667 |
19,000 |
96,833.00 |
-77,833.00 |
|
$7.25 |
N/A |
$137,750.00 |
| Schools |
Student Eligibility Data (School Year) |
N/A |
0 |
0 |
0 |
0 |
0 |
0 |
568,602.00 |
-568,602.00 |
|
$30.41 |
$40.45 |
$- |
| Student Eligibility Data (Summer) |
N/A |
287 |
1 |
287 |
1 |
0.5 |
144 |
47,384.00 |
-47,240.50 |
|
$30.41 |
$40.45 |
$5,803.90 |
| P-EBT Local Level Administrative Cost Reporting to State |
N/A |
287 |
1 |
287 |
1 |
0.5 |
144 |
94,767.00 |
-94,623.50 |
|
$30.41 |
$40.45 |
$5,803.90 |
| Schools Subtotal |
|
|
287 |
2 |
574 |
2 |
1 |
287 |
710,753 |
-710,466.00 |
|
$30.41 |
$40.45 |
$11,607.80 |
| State Agencies |
State Plan Submission- P-EBT (Schools + Child Care For School Year) |
NA |
0 |
0 |
0 |
0 |
0 |
0 |
53.00 |
-53.00 |
|
$38.13 |
$50.71 |
$- |
| State Plan Submission- P-EBT (Schools + Child Care For Summer) |
N/A |
0 |
0 |
0 |
0 |
0 |
0 |
53.00 |
-53.00 |
|
$38.13 |
$50.71 |
$- |
| P-EBT Household Eligibility Determination (Schools + Child Care) |
N/A |
0 |
0 |
0 |
0 |
0 |
0 |
2,165,000.00 |
-2,165,000.00 |
|
$38.13 |
$50.71 |
$- |
| Monthly P-EBT Reporting to FNS (Schools + Child Care) |
FNS-292B |
50 |
12 |
600 |
12 |
1 |
600 |
636.00 |
-36.00 |
|
$38.13 |
$50.71 |
$30,427.74 |
| P-EBT Administrative Cost Plan (100% funding) (Schools + Child Care) |
FNS-366A |
0 |
0 |
0 |
0 |
0 |
0 |
636.00 |
-636.00 |
|
$38.13 |
$50.71 |
$- |
| P-EBT Quarterly Administrative Cost Report (100% funding) (Schools + Child Care) |
SF-425 |
50 |
4 |
200 |
4 |
1 |
200 |
212.00 |
-12.00 |
|
$38.13 |
$50.71 |
$10,142.58 |
| P-EBT Reporting to FNS (Summer) |
|
0 |
1 |
0 |
0 |
0 |
0 |
27 |
-27 |
|
$38.13 |
$50.71 |
$- |
| SA Subtotal |
|
|
50 |
16.000 |
800 |
16 |
1.000 |
800 |
2,166,617.00 |
-2,165,817.00 |
0.00 |
|
|
$40,570.32 |
| Grand Total |
|
|
114,337 |
1.009 |
115,374 |
1 |
0.174 |
20,087 |
2,974,203.00 |
-2,954,116 |
0.00 |
|
|
$189,928.12 |
| Respondent Category |
Instruments |
Form |
Number of respondents |
Frequency of response |
Total Annual responses |
Responses per Respondent |
Hours per response |
Annual burden (hours) |
Previously Approved Annual Burden Hours |
Difference due to Program Change |
Hourly Wage Rate |
Fully Loaded ( Hourly wage + 33%) |
Total Annualized Cost of Respondent Burden |
| Individuals / Households |
P-EBT Application Submission |
N/A |
114,000 |
1 |
114,000 |
1 |
0.166666667 |
19,000 |
96,833.00 |
-77,833.00 |
$7.25 |
NA |
$137,750.00 |
| Schools |
Student Eligibility Data (Summer) |
N/A |
287 |
1 |
287 |
1 |
0.5 |
144 |
47,384.00 |
-47,240.50 |
$30.41 |
$40.45 |
$5,803.90 |
| P-EBT Local Level Administrative Cost Reporting to State |
N/A |
287 |
1 |
287 |
1 |
0.5 |
144 |
94,767.00 |
-94,623.50 |
$30.41 |
$40.45 |
$5,803.90 |
| Schools Subtotal |
|
|
287 |
2 |
574 |
2 |
1 |
287 |
142,151.00 |
-141,864.00 |
$30.41 |
$40.45 |
$11,607.80 |
| State Agencies |
Monthly P-EBT Reporting to FNS (Schools + Child Care) |
FNS-292B |
50 |
12 |
600 |
12 |
1 |
600 |
636.00 |
-36.00 |
$38.13 |
$50.71 |
$30,427.74 |
| P-EBT Quarterly Administrative Cost Report (100% funding) (Schools + Child Care) |
SF-425 |
50 |
4 |
200 |
4 |
1 |
200 |
212.00 |
-12.00 |
$38.13 |
$50.71 |
$10,142.58 |
| SA Subtotal |
|
|
50 |
16.000 |
800 |
16 |
1.000 |
800 |
848.00 |
-48.00 |
|
|
$40,570.32 |
| Grand Total |
|
|
114,337 |
1.009 |
115,374 |
1 |
0.174 |
20,087 |
97,681.00 |
-77,881.00 |
|
|
$189,928.12 |