Information Collection

Business

IC 191242 under ICR 201911-0584-003 · 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⚠️ Notice: This information collection may be referencing outdated material.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-57 Business Form
FNS-57 Report of Shipments Over, Short, and/or Damaged WBSCM Sc Attachment 13C FNS-57 WBSCM Screenshots.pptx Form
Attachment 18- SF-424 Application for Federal Assistance.pdf Attachment 18 SF-424 Application for Federal Assistance IC Document
Attachment 19- SF- 425 Federal Financial Report.pdf Attachment 19 SF-425 Federal Financial Report IC Document
Attachment 22- WBSCM FAQs and Tips.pdf Attachment 22 WBSCM FAQs and Tips IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Business	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 7 CFR 250.15(b) and (c) 7 CFR 250.35(d) 7 CFR 250.4(b) and (c) 7 CFR 247.30(d)(3) 7 CFR 250.30(c)(1) 7 CFR 251.10(a)(1), (a)(2), (a)(3) 7 CFR 250.37(a), (c), and (d) 7 CFR 250.14(b) and (d) 7 CFR 247.28(b) 7 CFR 250.34 7 CFR 250.33(a) 7 CFR 250.19(a) 7 CFR 250.30 (c), (d), (e), (f)(i) 7 CFR 250.11(b) 7 CFR 250.17(c) 7 CFR 240.4 7 CFR 250.12(f) 7 CFR 250.69(c),(d) 7 CFR 250.70(c),(d) 7 CFR 251.2(c)(2) 7 CFR 250.18 (b) 7 CFR 250.10(a) 7 CFR 250.58(a) 7 CFR 250.20(c)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FNS-57	Report of Shipments Over, Short, and/or Damaged WBSCM Screen Shot	Attachment 13C FNS-57 WBSCM Screenshots.pptx		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: 5,530	Number of Respondents for Small Entity: 44

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 27 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,913,741	1,609	1,912,132
Annual IC Time Burden (Hours)	762,659	617	762,042
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment 18 SF-424 Application for Federal Assistance	Attachment 18- SF-424 Application for Federal Assistance.pdf	11/26/2019
Attachment 19 SF-425 Federal Financial Report	Attachment 19- SF- 425 Federal Financial Report.pdf	11/26/2019
Attachment 22 WBSCM FAQs and Tips	Attachment 22- WBSCM FAQs and Tips.pdf	11/26/2019

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