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Food Distribution Forms (State and Local Government)
Food Distribution Programs (0584-AE05)
OMB: 0584-0293
IC ID: 43552
OMB.report
USDA/FNS
OMB 0584-0293
ICR 201305-0584-006
IC 43552
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0293 can be found here:
2023-07-21 - Revision of a currently approved collection
2019-11-26 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form FNS-7
Food Distribution Forms (State and Local Government)
Form
FNS-7 DESTINATION DATA FOR DELIVERY OF DESTINATION DATA FOR DE
FNS-7.pdf
Form
FNS-52 FOOD REQUISITION
FNS-52.pdf
Form
FNS-53 USDA MULTI-FOOD REQUISITION
FNS-53.pdf
Form
FNS-57 REPORT OF SHIPMENT RECEIVED OVER, SHORT AND/OR DAMAGED
FNS-57.pdf
Form
FNS-152 MONTHLY DISTRIBUTION OF DONATED FOODS TO FAMILY UNITS
FNS-152.pdf
Form
FNS-153 MONTHLY REPORT OF THE COMMODITY SUPPLEMENTAL FOOD PROGRA
FNS-153.pdf
Form
FNS-155 INVENTORY MANAGEMENT REGISTER
FNS-155.pdf
Form
FNS-667 REPORT OF THE EMERGENCY FOOD ASSISTANCE PROGRAM (TEFAP)
FNS-667.pdf
Form
SF 425 Financial Status Reports- ARRA FDPIR
SF-425 for 0293 ARRA 5-19-09.pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Food Distribution Forms (State and Local Government)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
7 CFR 240, 247, 250, 251, 253, 254 (To search for a specific CFR, visit the
Code of Federal Regulations.
)
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
FNS-7
DESTINATION DATA FOR DELIVERY OF DESTINATION DATA FOR DELIVERY OF
FNS-7.pdf
Yes
Yes
Fillable Printable
Form
FNS-52
FOOD REQUISITION
FNS-52.pdf
Yes
Yes
Fillable Printable
Form
FNS-53
USDA MULTI-FOOD REQUISITION
FNS-53.pdf
Yes
Yes
Fillable Fileable
Form
FNS-57
REPORT OF SHIPMENT RECEIVED OVER, SHORT AND/OR DAMAGED
FNS-57.pdf
Yes
Yes
Fillable Printable
Form
FNS-152
MONTHLY DISTRIBUTION OF DONATED FOODS TO FAMILY UNITS
FNS-152.pdf
Yes
Yes
Fillable Printable
Form
FNS-153
MONTHLY REPORT OF THE COMMODITY SUPPLEMENTAL FOOD PROGRAM AND QUARTERLY ADMINISTRATIVE FINANCIAL STATUS REPORT
FNS-153.pdf
Yes
Yes
Fillable Printable
Form
FNS-155
INVENTORY MANAGEMENT REGISTER
FNS-155.pdf
Yes
Yes
Fillable Printable
Form
FNS-667
REPORT OF THE EMERGENCY FOOD ASSISTANCE PROGRAM (TEFAP) ADMINISTRATIVE COSTS
FNS-667.pdf
Yes
Yes
Fillable Printable
Form
SF 425
Financial Status Reports- ARRA FDPIR
SF-425 for 0293 ARRA 5-19-09.pdf
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
Food and Nutrition Assistance
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
330
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
90 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
187,169
0
0
0
0
187,169
Annual IC Time Burden (Hours)
30,853
0
28
0
0
30,825
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.