OMB Control No.: 0584-0512
Expiration Date: xx/xx/xxxx
OMB
BURDEN
STATEMENT:
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
control
number
for
this
information
collection
is
0584-0512.
The
estimated
average
time required to
complete this information collection is 45 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. An
agency may not conduct or sponsor, and a person is not required to
respond to, a collection of information unless it displays a
currently valid OMB control number. Send comments regarding this
burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden, to:
U.S. Department of Agriculture, Food and Nutrition Services, Office
of Policy Support, ATTN: PRA (0584-xxxx*). Do not return the
completed form to this address.
Floor, Alexandria, VA 22314th1320
Braddock Place, 5th
Floor, Alexandria, VA 22314 ATTN: PRA (0584-0512). Do not
return the completed form to this address.
Healthy Meals Incentives
Semi-Annual Progress Report
This form should be completed on a semi-annual basis and returned to (cooperator) no later than 30 days after the reporting period. Provide information on activities that took place during the reporting period.
Provide the requested information below about the recipient organization.
Name of School Food Authority: ______________________________________________
Address: _____________________________________________________________________
City: ________________________________________________________________________
State: ________________________________________________________________________
ZIP: _________________________________________________________________________
Provide the requested information below about the primary point of contact for the grant project.
First Name: ___________________________________________________________________
Last Name: ___________________________________________________________________
Title: ________________________________________________________________________
Email: _______________________________________________________________________
Phone: _______________________________________________________________________
Provide the date the report was submitted below.
Date: ________________________________________________________________________
Provide a summary of progress for this reporting period. In the first column, include a description of the activity that took place this reporting period. In the second column, describe the purpose of the activity. In the third column, mark the status of the activity.
A61
Activity and Description |
Activity Purpose |
Activity Status |
|
|
[ ] Not yet started [ ] Delayed [ ] In progress [ ] Complete
|
+Add additional activities [User will be able to add rows for additional activities as needed]
Provide a summary of challenges faced during this reporting period and how they were overcome: ____________________________________________________________________
Highlight your greatest achievements for this reporting period. __________________________
Are you on time and budget with your grant activities?
[ ] Yes [ ] No
If so, check type: [ ] Budget [ ] Timeline [ ] N/A
Please describe: ________________________________________________________________
Describe activities planned for the next reporting period: ________________________________
Do you anticipate any changes in timeline, activities, or cost?
[ ] Yes [ ] No
If yes, please describe: ___________________________________________________________
Have you applied to receive a Healthy Meals Incentive Award?
[ ] Yes [ ] No
If yes, list the award(s) for which you have applied: ____________________________________
When did you apply for the award(s): _______________________________________________
Have you received a Healthy Meals Incentive Award?
[ ] Yes [ ] No
If yes, list the award(s) received: ___________________________________________________
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Modified | 0000-00-00 |
File Created | 0000-00-00 |