Information Collection

FORMS-806-A, Claim for Reimbursement (National School Lunch and School Breakfast Programs) and FNS-806-B, Claim for Reimbursement (Special Milk Program for Children), 7 CFR Part 210, Part 220 & 215

IC 3005 under ICR 201302-0584-011 · OMB 0584-0284.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0284 can be found here:

Documents and Forms

Document Name Document Type
Form FNS 806-A FORMS-806-A, Claim for Reimbursement (National School Lunch and School Breakfast Programs) and FNS-806-B, Claim for Reimbursement (Special Milk Program for Children), 7 CFR Part 210, Part 220 & 215 Form and Instruction
FNS 806-A School Lunch/Breakfast/Snack Claim for Reimbursement FNS-806A.pdf Form and Instruction
FNS 806-B Milk Claim for Reimbursement FNS-806B.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	FORMS-806-A, Claim for Reimbursement (National School Lunch and School Breakfast Programs) and FNS-806-B, Claim for Reimbursement (Special Milk Program for Children), 7 CFR Part 210, Part 220 & 215	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FNS 806-A	School Lunch/Breakfast/Snack Claim for Reimbursement	FNS-806A.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	FNS 806-B	Milk Claim for Reimbursement	FNS-806B.pdf		Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 210	Number of Respondents for Small Entity: 210

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	2,520	-276	2,796
Annual IC Time Burden (Hours)	1,260	-138	1,398
Annual IC Cost Burden (Dollars)	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.