Information Collection

250.17(e) - Other Reporting - Food Requisition Form

IC 44738 under ICR 200608-0584-007 · OMB 0584-0293.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0293 can be found here:

Documents and Forms

Document Name Document Type
Form FNS-52 250.17(e) - Other Reporting - Food Requisition Form Form and Instruction
FNS-52 Food Requisition FNS-52.pdf www.fns.usda.gov/fdd/forms/FNS-52.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	250.17(e) - Other Reporting - Food Requisition Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 7 CFR 250.17(e)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FNS-52	Food Requisition	FNS-52.pdf	http://www.fns.usda.gov/fdd/forms/FNS-52.pdf	Yes	No	Printable Only

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 81	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 50 %

	Requested	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	9,072	9,072
Annual IC Time Burden (Hours)	18,144	18,144
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.