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[{"$nulls":11},"Attachment 2"]
["FORM APPROVED OMB NO. 0584-0045"]
["U.S. DEPARTMENT OF AGRICULTURE - Food and Nutrition Service"]
["ADDENDUM TO WIC FINANCIAL MANAGEMENT AND PARTICIPATION REPORT - NSA EXPENDITURES"]
["Public reporting burden for this collection of information is estimated to average 1.7 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.  An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.  Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to: U.S. Department of Agriculture, Food and Nutrition Services, Office of Research, Nutrition and Analysis, Alexandria, VA 22302 (0584-0054).  Do not return the completed form to this address."]
["1. STATE AGENCY NAME\n\n     ",null,null,null,"2. 7 - DIGIT CODE\n    ",{"$nulls":5},"3. PERIOD COVERED\n\n    "]
[{"$nulls":4},"4. FISCAL YEAR\n    "]
["STATE LEVEL EXPENDITURES",{"$nulls":4},"LOCAL LEVEL EXPENDITURES"]
["5. FUNCTIONS/\n    ACTIVITIES",null,"01\n GENERAL \nADMIN","02\n CLIENT \nSERVICES","03\n NUTRITION EDUCATION","04\n BREAST \nFEEDING","05\n GENERAL \nADMIN","06\n CLIENT \nSERVICES","07\n NUTRITION EDUCATION","08\n BREAST \nFEEDING","09\n \nTOTAL"]
["a. TOTAL FEDERAL\n    OUTLAYS"]
["b. TOTAL STATE\n    OUTLAYS\n    (OPTIONAL)"]
["6. INDIRECT EXPENSE AMOUNT:",{"$nulls":6},"Signature of Certifying Official"]
[]
[]
[{"$nulls":7},"Name and Title"]
[]
[]
[{"$nulls":7},"Date Report Submitted",null,null,"Telephone Number\n(Include Area Code)"]
[]
[]
["REMARKS: "]
["STAMP/CERTIFY DATE \n",null,null,"LAST UPDATED BY \n",null,null,null,"LAST UPDATED ON \n"]
["FORM FNS-798 (7-02)",{"$nulls":6},"Printed on 05/12/2008 10:12:24 AM"]
["FPRS Electronic Version",{"$nulls":6},"Page 1 of 1"]