Information Collection

Worksheet FNS 152, 153 & 667 OMB# 0293

IC 204625 under ICR 201701-0584-003 · OMB 0584-0594.

⚠️ Notice: This information collection may be referencing outdated material.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 153 Worksheet FNS 152, 153 & 667 OMB# 0293 Form and Instruction
FNS-152 April 2014.pdf fprs.fns.usda.gov Instruction
FNS-153 April 2014.pdf fprs.fns.usda.gov Instruction
FNS 667 April 2014.pdf fprs.fns.usda.gov Instruction
FNS 152 Monthly Distribution of Donated Food to Family Units FNS-152 Screenshots V2.pdf fprs.fns.usda.gov/Home/Reminder.aspx Form and Instruction
FNS 153 Monthly Report of the CSFP and Quarterly Administrative FNS-153 Screenshots V2.pdf fprs.fns.usda.gov/Home/Reminder.aspx Form and Instruction
FNS 667 Report of The Emergency Food Assistance Programs (TEFAP) FNS-667 Screenshots V2.pdf fprs.fns.usda.gov/Home/Reminder.aspx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Worksheet FNS 152, 153 & 667 OMB# 0293	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Mandatory

CFR Citation: 7 CFR 250.17 7 CFR 251.10

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FNS 153	Monthly Report of the CSFP and Quarterly Administrative Financial Status Report	FNS-153 Screenshots V2.pdf	https://fprs.fns.usda.gov/Home/Reminder.aspx	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FNS 667	Report of The Emergency Food Assistance Programs (TEFAP) Administrative Costs	FNS-667 Screenshots V2.pdf	https://fprs.fns.usda.gov/Home/Reminder.aspx	Yes	Yes	Fillable Fileable Signable
Instruction			FNS-152 April 2014.pdf	https://fprs.fns.usda.gov	Yes	Yes	Fillable Fileable Signable
Instruction			FNS-153 April 2014.pdf	https://fprs.fns.usda.gov	Yes	Yes	Fillable Fileable Signable
Instruction			FNS 667 April 2014.pdf	https://fprs.fns.usda.gov	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FNS 152	Monthly Distribution of Donated Food to Family Units	FNS-152 Screenshots V2.pdf	https://fprs.fns.usda.gov/Home/Reminder.aspx	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: 111	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	2,111	2,111
Annual IC Time Burden (Hours)	7,468	7,468
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.