Attachment G - Excel Burden Chart for OMB# 0584-0005 7 CFR Part 215 Special Milk Program for Children

---

Overview

RecordKeeping
Reporting
60 day Summ
Burden Summary
Notes

---

Sheet 1: RecordKeeping

Attachment G - Excel Burden Chart for OMB# 0584-0005 7 CFR Part 215 Special Milk Program for Children
Recordkeeping
				A	B	C = (A*B)	D	E= (C*D)	F	G =E-F
Child Nutrition Program	CFR Citation	Regulation	Form Number	Estimated # Record-keepers	Records Per Recordkeeper	Total Annual Records	Estimated Avg. # of Hours Per Record	Estimated Total Hours	Current OMB Approved Burden Hours	Total Difference
State Agency Level
Milk	215.7	SA maintains applications submitted by, and agreements executed with, SFAs and sponsors.		54	63.80	3,445	0.10	344.52	345	0
Milk	215.11(b)	SA maintains documentation of compliance reviews, site visits and Program assistance.		54	5.00	270	0.20	54.00	54	0
Milk	215.11(c)(1)	SA maintains Program records as necessary to support the reimbursement payments and reports.		54	24.00	1,296	0.10	129.60	130	0
Milk				54	766.00	41,364	0.10	4136.40	4,136	0
Milk	215.12	SA maintains all records of action taken on disallowed claims.		54	2	108	0.33	35.64	36	0
Milk	215.13(a)	A-133 Audit, Audit Plan, and Management Evaluations including records of the receipt and expenditure of funds under the Program.		54	1	54	0.26	14.04	14	0
		State Agency Level Total		54	861.80	46,537	0.10	4,714	4,714	0
School Food Authority Level (Local Sites)
Milk	215.7	SFA maintains Program records to support claims.		3,155	10	31,550	0.20	6,310.00	6,310	0
Milk	215.14a	SFA compliance with procurement requirements		2,679	1	2,679	0.20	535.80	536	0
		School Food Authority Level Total		3,155	10.85	34,229	0.20	6,846	6,846	0
NonProfit Child Care Institution Level (Local Site)
Milk	215.7	CCI maintains Program records to support claims.		290	10	2,900	0.20	580.00	580	0
		NonProfit Child Care Institution Level Total		290	10	2,900	0.20	580	580	0
		Total Recordkeeping Burden		3,499	23.91	83,666	0.15	12,140	12,140	0
			Child Nutrition Program	Estimated # Record-keepers	Records Per Recordkeeper	Total Annual Records	Estimated Avg. # of Hours Per Record	Estimated Total Hours	Current OMB Approved Burden Hours	Total Difference
			Milk	3,499	23.91146	83,666	0.145	12,140	12,140	0
			0	-	-	-	-	-	-	-
			0	-	-	-	-	-	-	-
			0	-	-	-	-	-	-	-	"Please un-hide the colums 40-47 for more data"
			0	-	-	-	-	-	-	-
			Total	3,499	#REF!	#REF!	#REF!	#REF!	#REF!	#REF!

---

Sheet 2: Reporting

Reporting
				A	B	C = (A*B)	D	E= (C*D)	F	G =E-F
Child Nutrtition Program	CFR Citation	Regulation	Form Number	Estimated # Respondents	Responses per Respondent	Total Annual Records	Estimated Avg. # of Hours Per Response	Estimated Total Hours	Current OMB Approved Burden Hours	Total Difference	Justification		Data Validation - List
State Agency Level																Milk
Milk	215.5(a)	SA requests funds to pay SMP claims.		54	24	1,296	0.25	324	324	0
		State Agency Level Total		54	24.00	1,296	0.25	324	324	0
School Food Authority Level (Local Sites)
Milk	§215.7(c)	SFA submit an application to SA to operate the SMP.		3,155	1	3,155	0.25	789	789	0
		School Food Authority Level Total		3,155	1.00	3,155	0.25	789	789	0
Non-Profit Child Care Institution Level (Local Site)
Milk	§215.7(c)	CCI submit an application to SA to operate the SMP.		290	1.00	290	0.25	72	72
		Non-Profit Child Care Institution Level Total		290	1	290	0.25	72	72	0
		Total Reporting Burden		3,499	1.35	4,741	0.25	1,185	1,185	0
			Child Nutrtition Program	Estimated # Respondents	Responses per Respondent	Total Annual Records	Estimated Avg. # of Hours Per Response	Estimated Total Hours	Current OMB Approved Burden Hours	Total Difference
			Milk	3,499	1.35496	4,741	0.25	1,185	1,185	0
			0	-	-	-	-	-	-	-
			0	-	-	-	-	-	-	-
			0	-	-	-	-	-	-	-		"Please un-hide the colums 40-47 for more data"
			0	-	-	-	-	-	-	-
			Total	3,499	#REF!	#REF!	#REF!	#REF!	#REF!	#REF!

---

Sheet 3: 60 day Summ

SUMMARY OF BURDEN RECORDKEEPING & REPORTING
TOTAL NO. RESPONDENTS	3,499
AVERAGE NO. RESPONSES PER RESPONDENT	25.2664
TOTAL ANNUAL RESPONSES	88,407
AVERAGE HOURS PER RESPONSE	0.150725834547412
TOTAL BURDEN HOURS FOR PART 215 WITH REVISION	13,325
CURRENT OMB INVENTORY FOR PART 215	13,325		This is the Current OMB Approved Burden Hrs column 'J'
DIFFERENCE (NEW BURDEN REQUESTED WITH REVISION)	0

---

Sheet 4: Burden Summary

OMB Control #0584-0005 - Burden Summary - 7 CFR Part 215, Special Milk Program Regulations
	Estimated # Respondents	Responses Per Respondent	Total Annual Responses (Col. BxC)	Estimated Avg. # of Hours Per Response	Estimated Total Hours (Col. DxE)
Recordkeeping
State Agency Level	54	861.80	46,537	0.10	4,714
Institution Level	3,155	10.85	34,229	0.20	6,846
Site Level	290		2,900		580
Recordkeeping Total	3,499	23.91	83,666	0.15	12,140
Reporting
State Agency Level	54	24.00	1,296	0.25	324
Institution Level	3,155	1.00	3,155	0.25	789
Site Level	290		290		72
Reporting Total	3,499	1.35	4,741	0.25	1,185
TOTAL BURDEN FOR (Title)	3,499	25.2664	88,407	0.1507	13,325
Add total number of recordkeepers to the total annual responses.

---

Sheet 5: Notes

Date	User Initials	Comments
11/1/11	SW	This is a DRAFT of the Special Milk Program Burden doc using the redesigned template
11/2/11	SW	Burden reduction for renewal. Need to eliminate burden associated with the FNS-10 and FNS-777 to not duplicate burden in those ICRs.
11/22/11	BB	Removed duplicate burden at site level; regulatory language puts burden of information collection at insitution level
1/11/12	BB	revised notice to incorporate PRAB comments; returned to PRAB 1.12.12
3/20/15	SW	Burden corrections for renewal.