Worksheet FNS 13 OMB#0075

Food Programs Reporting System (FPRS)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0594 can be found here:

Documents and Forms

Document Name Document Type
Form FNS 13 Worksheet FNS 13 OMB#0075 Form and Instruction
FNS-13 April 2014.pdf fprs.fns.usda.gov Instruction
FNS 13 Annual Report of State Revenue Matching FNS-13 Screenshots V2.pdf fprs.fns.usda.gov Form and Instruction

Information Collection (IC) Details

IC Title:	Worksheet FNS 13 OMB#0075	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 7 CFR 210.17

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FNS 13	Annual Report of State Revenue Matching	FNS-13 Screenshots V2.pdf	https://fprs.fns.usda.gov	Yes	Yes	Fillable Fileable Signable
Instruction			FNS-13 April 2014.pdf	https://fprs.fns.usda.gov	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 57	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	57	57
Annual IC Time Burden (Hours)	4,560	4,560
Annual IC Cost Burden (Dollars)	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.