Information Collection

Food Distribution Forms (State and Local Government)

IC 43552 under ICR 201701-0584-004 · 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⚠️ Notice: This information collection may be referencing outdated material.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 Food Distribution Forms (State and Local Government) Form
FNS-7 DESTINATION DATA FOR DELIVERY OF DESTINATION DATA FOR DE FNS-7.pdf Form
FNS-52 FOOD REQUISITION FNS-52.pdf Form
FNS-53 USDA MULTI-FOOD REQUISITION FNS-53.pdf Form
FNS-57 REPORT OF SHIPMENT RECEIVED OVER, SHORT AND/OR DAMAGED FNS-57.pdf Form
FNS-152 MONTHLY DISTRIBUTION OF DONATED FOODS TO FAMILY UNITS FNS-152.pdf Form
FNS-153 MONTHLY REPORT OF THE COMMODITY SUPPLEMENTAL FOOD PROGRA FNS-153.pdf Form
FNS-155 INVENTORY MANAGEMENT REGISTER FNS-155.pdf Form
FNS-667 REPORT OF THE EMERGENCY FOOD ASSISTANCE PROGRAM (TEFAP) FNS-667.pdf Form
SF 425 Financial Status Reports- ARRA FDPIR SF-425 for 0293 ARRA 5-19-09.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Food Distribution Forms (State and Local Government)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 7 CFR 240, 247, 250, 251, 253, 254 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FNS-52	FOOD REQUISITION	FNS-52.pdf	Yes	Yes	Fillable Printable
Form	FNS-53	USDA MULTI-FOOD REQUISITION	FNS-53.pdf	Yes	Yes	Fillable Fileable
Form	FNS-57	REPORT OF SHIPMENT RECEIVED OVER, SHORT AND/OR DAMAGED	FNS-57.pdf	Yes	Yes	Fillable Printable
Form	FNS-7	DESTINATION DATA FOR DELIVERY OF DESTINATION DATA FOR DELIVERY OF	FNS-7.pdf	Yes	Yes	Fillable Printable
Form	FNS-152	MONTHLY DISTRIBUTION OF DONATED FOODS TO FAMILY UNITS	FNS-152.pdf	Yes	Yes	Fillable Printable
Form	FNS-153	MONTHLY REPORT OF THE COMMODITY SUPPLEMENTAL FOOD PROGRAM AND QUARTERLY ADMINISTRATIVE FINANCIAL STATUS REPORT	FNS-153.pdf	Yes	Yes	Fillable Printable
Form	FNS-155	INVENTORY MANAGEMENT REGISTER	FNS-155.pdf	Yes	Yes	Fillable Printable
Form	FNS-667	REPORT OF THE EMERGENCY FOOD ASSISTANCE PROGRAM (TEFAP) ADMINISTRATIVE COSTS	FNS-667.pdf	Yes	Yes	Fillable Printable
Form	SF 425	Financial Status Reports- ARRA FDPIR	SF-425 for 0293 ARRA 5-19-09.pdf	Yes	Yes	Fillable Printable

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 20,866	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 90 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	703,450	-34,630	738,080
Annual IC Time Burden (Hours)	94,092	-2,627	96,719
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.