Information Collection

Worksheet FNS 101 (3 respondents from CMNI and 2719 and 134 SLT OMB# 0025

IC 204621 under ICR 202303-0584-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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
FNS-101.pdf fprs.fns.usda.gov Instruction
FNS-101.pdf fprs.fns.usda.gov Instruction
FNS 101 Participation in Food Programs by Race FNS-101.docx fprs.usda.fns.gov Form
FNS 101 Participation in Food Programs by Race FNS-101.docx fprs.usda.fns.gov Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Worksheet FNS 101 (3 respondents from CMNI and 2719 and 134 SLT OMB# 0025	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 7 CFR 247.29

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			FNS-101.pdf	https://fprs.fns.usda.gov	Yes	Yes	Fillable Fileable Signable
Form	FNS 101	Participation in Food Programs by Race	FNS-101.docx	https://fprs.usda.fns.gov	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: 2,856	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	2,856	-252	3,108
Annual IC Time Burden (Hours)	5,714	-490	6,204
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.