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Forms & OMB Circulars
food distribution website

This page provides non-electronic PDF versions of food distribution delivery and shipping forms. These forms will be available as "eForms" after approval from OMB. Then States and participants will be able to complete these forms online and submit them to USDA electronically. This page also provides links to OMB circulars used by State and local governments for audit purposes and data collection procedures. 

OMB & Treasury Circulars
 

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All OMB Circulars in Sequence

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OMB Circular A-133, Revised 06/27/97: Audits of States, Local Governments, and Non-Profit Organizations.

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OMB Circulars A-133 Compliance Supplement - March 2004.
bullet  Data Collection Form (Form SF-SAC).
bullet  Department of the Treasury's Listing of Approved Sureties - Department Circular No. 570

Instructions 

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709-5 - Shipment and Receipt of Foods 

Forms (non-fillable electronic versions)  

Form No.

Title

OMB No.

 pdf icon FNS 7 Destination Data for Delivery of Donated Foods - pdf format 0584-0293
 pdf icon FNS 57 Report of Shipment Received, Over, Short and/or Damaged 0584-0293
 pdf icon FNS-52  Food Requisition 0584-0293
 pdf icon FNS-53 Multi-Food Requisition 0584-0293
 pdf icon FNS-74 Federal-State Agreement for Child Nutrition and Food Distribution Programs
 pdf icon FNS-101 Participation in Food Programs - By Race 0584-0025
 pdf icon FNS-152 Monthly Distribution of Donated Foods to Family Units 0584-0293
 pdf icon FNS-153 Monthly Report of the Commodity Supplemental Food Program and Quarterly Administrative Financial Status Report 0584-0293
 pdf icon FNS-155 Inventory Management Register 0584-0293
 pdf icon FNS-292 Report of Coupon Issuance and Commodity Distribution for Disaster Relief

0584-0037

 pdf icon FNS-663 Commodity Acceptability Progress Report  0584-0293
 pdf icon FNS-667 Report of The Emergency Food Assistance Program (TEFAP) Administrative Costs   0584-0293
 pdf icon FSA-21 Public Voucher - Commodity Programs. 

(Note: This a Fillable Version of the form, but you will need a full version of Adobe Acrobat installed on your PC to be able to save a filled-in copy of this PDF form). 
FSA Form

 

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Last Modified: 10/26/2004