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Federal forms, ICRs, and supporting documents

Information Collection

FNS-843, FNS 844 (State Agencies)

IC 206841 under ICR 201607-0584-001 · OMB 0584-0584.

Documents and Forms
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Information Collection (IC) Details

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FNS-843, FNS 844 (State Agencies)
 
No Modified
 
Mandatory
 
7 CFR 226.6(c)(7)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form FNS-844 (online) Report of Disqualification from Participation - Individually Disqualified Responsible Principal/Individual or Day Care Home Provider Attachment A-2 FNS-844.docx www.fns.usda.gov Yes Yes Fillable Fileable
Form FNS-843 (online) FNS-843 Report of Disqualification from Participation - Institution and Responsible Principals/Individuals Attachment A-1 FNS-843.docx www.fns.usda.gov Yes Yes Fillable Fileable

Income Security Food and Nutrition Assistance

USDA/FNS-11 Information on Persons Identified as Responsible for Serious Deficiencies, Proposed for Disqualification, or Disqualified to Participate as Principals or Family Day Care Home Operators in   69 FR 6933

56 0
   
State, Local, and Tribal Governments
 
   100 %

  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 1,568 0 0 0 0 1,568
Annual IC Time Burden (Hours) 784 0 0 0 0 784
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.