FNS 366B Form Chan PROGRAM AND BUDGET SUMMARY STATEMENT PART B - PROGRAM AC

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Overview

Proposed Revision
Existing

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Sheet 1: Proposed Revision

								OMB APPROVED NO. 0584-0594
								Expiration Date: XX/XX/XXXX
U.S. DEPARTMENT OF AGRICULTURE - FOOD AND NUTRITION SERVICE					1. STATE
PROGRAM AND BUDGET SUMMARY STATEMENT					2. REPORT PERIOD
PART B - PROGRAM ACTIVITY STATEMENT								TO
						MONTH	YEAR		MONTH	YEAR
CERTIFICATIONS	(a) APPROVALS	(b) DENIALS	(c) TOTAL APPROVED AND DENIED	APPROVED OVERDUE APPLICATIONS
				(d) 1 - 30 DAYS	(e) 31 - 60 DAYS	(f) 61 - 90 DAYS	(g) 91+ DAYS
3. INITIAL APPLICATIONS
4. RECERTIFICATIONS
5. TOTAL
6a. EXPEDITED SERVICE - INITIAL APPLICATIONS
6b. EXPEDITED SERVICE - RECERTIFICATIONS
FAIR HEARINGS	(a) HEARINGS REQUESTED	(b) HEARINGS HELD	(c) DECISIONS UPHELD	(d) DECISIONS REVERSED	(e) DECISIONS OVERDUE	(f) WITHDRAWN REQUESTS
7. ACTIVITY
FRAUD INVESTIGATIONS	ELIGIBILITY FRAUD					TRAFFICKING				COMBINED
	(a) EVIDENCE FOUND TO REDUCE OR DENY BENEFITS	(b) NO EVIDENCE FOUND TO REDUCE OR DENY BENEFITS	(c) RESULTED IN REFERRAL FOR ADH OR PROSECUTION	(d) AVERAGE # OF DAYS PER CONCLUDED INVESTIGATION	(e) OPEN INVESTIGATIONS	(f) RESULTED IN REFERRAL FOR ADH OR PROSECUTION	(g) RESULTED IN NO REFERRAL FOR ADH OR PROSECUTION	(h) AVERAGE # OF DAYS PER CONCLUDED INVESTIGATION	(i) OPEN INVESTIGATIONS	(j) INVESTIGATOR HOURS
8. CASES / DAYS / HOURS
ADMINISTRATIVE DISQUALIFICATION HEARINGS	ELIGIBILITY FRAUD				TRAFFICKING				COMBINED
	(a) ADH CONCLUDED, INDIVIDUAL DISQUALIFIED	(b) WAIVER SIGNED, INDIVIDUAL DISQUALIFIED	(c) ADH CONCLUDED, INDIVIDUAL NOT DISQUALIFIED	(d) AMOUNT SUBJECT TO CLAIM	(e) ADH CONCLUDED, INDIVIDUAL DISQUALIFIED	(f) WAIVER SIGNED, INDIVIDUAL DISQUALIFIED	(g) ADH CONCLUDED, INDIVIDUAL NOT DISQUALIFIED	(h) AMOUNT SUBJECT TO CLAIM	REFERRED INDIVIDUALS AWAITING SCHEDULING		(k) DECISIONS NOTICES OVERDUE
									(i) 91-180 DAYS	(j) 181+ DAYS
9. INDIVIDUALS / $ / NOTICES
PROSECUTIONS	ELIGIBILITY FRAUD				TRAFFICKING				COMBINED
	(a) PROSECUTION CONCLUDED, INDIVIDUAL DISQUALIFIED	(b) DCA SIGNED, INDIVIDUAL DISQUALIFIED	(c) PROSECUTION CONCLUDED, INDIVIDUAL NOT DISQUALIFIED	(d) AMOUNT SUBJECT TO CLAIM	(e) PROSECUTION CONCLUDED, INDIVIDUAL DISQUALIFIED	(f) DCA SIGNED, INDIVIDUAL DISQUALIFIED	(g) PROSECUTION CONCLUDED, INDIVIDUAL NOT DISQUALIFIED	(h) AMOUNT SUBJECT TO CLAIM	(i) AVERAGE # OF DAYS PER CONCLUDED PROSECUTION
10. INDIVIDUALS / $ / DAYS

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Sheet 2: Existing

								OMB APPROVED NO. 0584-0594
								Expiration Date: XX/XX/XXXX
U.S. DEPARTMENT OF AGRICULTURE - FOOD AND NUTRITION SERVICE					1. STATE
PROGRAM AND BUDGET SUMMARY STATEMENT					2. REPORT PERIOD
PART B - PROGRAM ACTIVITY STATEMENT								TO
						MONTH	YEAR		MONTH	YEAR
CERTIFICATIONS	(a) APPROVALS	(b) DENIALS	(c) TOTAL APPROVED AND DENIED	APPROVED OVERDUE APPLICATIONS
				(d) 1 - 30 DAYS	(e) 31 - 60 DAYS	(f) 61 - 90 DAYS	(g) 91+ DAYS
3. INITIAL APPLICATIONS
4. RECERTIFICATIONS
5. TOTAL
6. EXPEDITED SERVICE
FAIR HEARINGS	(a) HEARINGS REQUESTED	(b) HEARINGS HELD	(c) DECISIONS UPHELD	(d) DECISIONS REVERSED	(e) DECISIONS OVERDUE	(f) WITHDRAWN REQUESTS
7. ACTIVITY
FRAUD INVESTIGATIONS	ELIGIBILITY FRAUD					TRAFFICKING				COMBINED
	(a) EVIDENCE FOUND TO REDUCE OR DENY BENEFITS	(b) NO EVIDENCE FOUND TO REDUCE OR DENY BENEFITS	(c) RESULTED IN REFERRAL FOR ADH OR PROSECUTION	(d) AVERAGE # OF DAYS PER CONCLUDED INVESTIGATION	(e) OPEN INVESTIGATIONS	(f) RESULTED IN REFERRAL FOR ADH OR PROSECUTION	(g) RESULTED IN NO REFERRAL FOR ADH OR PROSECUTION	(h) AVERAGE # OF DAYS PER CONCLUDED INVESTIGATION	(i) OPEN INVESTIGATIONS	(j) INVESTIGATOR HOURS
8. CASES / DAYS / HOURS
ADMINISTRATIVE DISQUALIFICATION HEARINGS	ELIGIBILITY FRAUD				TRAFFICKING				COMBINED
	(a) ADH CONCLUDED, INDIVIDUAL DISQUALIFIED	(b) WAIVER SIGNED, INDIVIDUAL DISQUALIFIED	(c) ADH CONCLUDED, INDIVIDUAL NOT DISQUALIFIED	(d) AMOUNT SUBJECT TO CLAIM	(e) ADH CONCLUDED, INDIVIDUAL DISQUALIFIED	(f) WAIVER SIGNED, INDIVIDUAL DISQUALIFIED	(g) ADH CONCLUDED, INDIVIDUAL NOT DISQUALIFIED	(h) AMOUNT SUBJECT TO CLAIM	REFERRED INDIVIDUALS AWAITING SCHEDULING		(k) DECISIONS NOTICES OVERDUE
									(i) 91-180 DAYS	(j) 181+ DAYS
9. INDIVIDUALS / $ / NOTICES
PROSECUTIONS	ELIGIBILITY FRAUD				TRAFFICKING				COMBINED
	(a) PROSECUTION CONCLUDED, INDIVIDUAL DISQUALIFIED	(b) DCA SIGNED, INDIVIDUAL DISQUALIFIED	(c) PROSECUTION CONCLUDED, INDIVIDUAL NOT DISQUALIFIED	(d) AMOUNT SUBJECT TO CLAIM	(e) PROSECUTION CONCLUDED, INDIVIDUAL DISQUALIFIED	(f) DCA SIGNED, INDIVIDUAL DISQUALIFIED	(g) PROSECUTION CONCLUDED, INDIVIDUAL NOT DISQUALIFIED	(h) AMOUNT SUBJECT TO CLAIM	(i) AVERAGE # OF DAYS PER CONCLUDED PROSECUTION
10. INDIVIDUALS / $ / DAYS