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OMB APPROVED NO. 0584-0332 Expiration Date: 08/31/2028
U.S.DEPARTMENT OF AGRICULTURE
AND FOOD NUTRITION SERVICE For FNS Use Onty FEDERAL-STATE Agreement Number SUPPLEMENTAL [
NUTRITION PROGRAMS AGREEMENT
This information is being collected to assist the Food and Nutrition Service in entering into written agreements with State agencies desiring to administer the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), the WIC Farmers’ Market Nutrition Program (FMNP), and/or the Seniors Farmers’ Market Nutrition Program (SFMNP). This is a mandatory collection and FNS uses the information to make funds available to State agencies for the administration of one or more programs. This collection does not request any personally identifiable information under the Privacy Act of 1974. According to the: Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB contro! number. The valid OMB control number for this information collection is 0584-0332. The time required to complete this information collection is estimated to average .125 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: U.S. Department of Agriculture, Food and Nutrition Service, Office of Policy Support, 1320 Braddock Place, Sth Floor, Alexandria, VA 22306 ATTN: PRA (0584-0332). Do not return the completed form to this address.
1. NAME OF STATE AGENCY 2. STATE 4, PROGRAM(S) ADMINISTERED Alabama Department of Public Health AL wic Bureau of Family Health Services . 3. EFFECTIVE DATE [1 wc FARMERS’ MARKET Women, Infants, and Children (WIC) Program NUTRITION PROGRAM 10/01/2026 ([]_ SENIOR FARMERS’ MARKET NUTRITION PROGRAM
5. UNIVERSAL IDENTIFIER NUMBER(S)
WDVJK7FUBBA6
No monies or other benefits may be paid out under this program unless this Agreement is completed and filed as required by existing regulations (7 CFR Parts 246, 248, and 249).
FNS-339 (6/25) Previous Edition Obsolete S B U Electronic Form Version Designed in AEM 6.4 Version