| Appendix H: Burden Table |
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| Respondents |
Form |
Estimated Number of Respondents |
Responses Annually Per Respondent |
Total Annual Responses |
Estimated Average Number of Hours Per Response |
Estimated Total Annual Burden Hours |
Previous Submission: Total Burden Hours |
Difference due to Program Changes |
Difference Due to Program Adjustments |
Total Difference |
Explanation of Difference |
Hourly Wage Rate |
Total Annualized Cost of Respondent Burden |
| Reporting Burden |
| State, Territory, and Indian Tribal Government Agencies (Respondent types: WIC - 89; FMNP - 50; SFMNP - 55) |
FNS-339 |
132 |
1 |
132 |
0.125 |
16.5 |
15.875 |
0 |
0.625 |
0.625 |
Increase in number of State agencies submitting form. |
$50.85 |
$839.03 |
| Recordkeeping Burden |
| State, Territory, and Indian Tribal Government Agencies (Respondent types: WIC - 89; FMNP - 50; SFMNP - 55) |
FNS-339 |
132 |
1 |
132 |
0.125 |
16.5 |
15.875 |
0 |
0.625 |
0.625 |
Increase in number of State agencies submitting form. |
$50.85 |
$839.03 |
| Total Reporting and Recordkeeping Burden |
132* |
2 |
264 |
0.125 |
33.00 |
31.75 |
0.00 |
1.25 |
1.25 |
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$1,678.05 |
| Attachment C - Federal-State Supplemental Nutrition Programs Agreement (FNS-339) Burden Table *The total number of respondents includes an unduplicated count of respondents that are responsible for the operation of 88 WIC Programs, 50 FMNP Programs, and 56 SFMNP Programs: 58 State agencies solely operate WIC, 3 State agencies solely operate FMNP ; 24 State agencies solely operate SFMNP ; 15 State agencies operate both WIC and FMNP; 17 State agencies operate both FMNP and SFMNP; and 15 State agencies operate WIC, FMNP, and SFMNP. |
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