Information Collection

Fns 640

IC 223716 under ICR 201904-0584-002 · 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⚠️ Notice: This information collection may be referencing outdated material.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 640 (A/B) (scr FNS 640 Form and Instruction
FNS-640 sheet A.pdf Instruction
FNS-640 sheet B.pdf Instruction
FNS 640 (A/B) (scr Administrative Review Report CN FNS-640.jpg www.fprs.gov Form and Instruction
FNS 640 (A/B) (scr Administrative Review Report CN FNS-640 Errors.jpg Form and Instruction
FNS-640 (A/B) (scr Administrative Review Report CN FNS-640 Warnings.jpg Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	FNS 640	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

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 640 (A/B) (screenshot1)	Administrative Review Report	CN FNS-640.jpg	www.fprs.gov	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FNS 640 (A/B) (screenshot2)	Administrative Review Report	CN FNS-640 Errors.jpg		Yes	Yes	Fillable Fileable Signable
Form and Instruction	FNS-640 (A/B) (screenshot3)	Administrative Review Report	CN FNS-640 Warnings.jpg		Yes	Yes	Fillable Fileable Signable
Instruction			FNS-640 sheet A.pdf		Yes	Yes	Fillable Fileable Signable
Instruction			FNS-640 sheet B.pdf		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: 56	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	56	0	56
Annual IC Time Burden (Hours)	280	140	140
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.