Form FNS-543 USDA NATIONAL HUNGER CLEARINGHOUSE DATABASE FORM

OMB Control No. 0584-0474
Expiration Date: xx/xx/xxxx

USDA National Hunger Clearinghouse Database Form (Online)
Draft Revised OMB Form No. 0584-0474
August 13, 2024

USDA National Hunger Hotline Database Form
Add your food assistance service or resource to the USDA database so that we can connect people in
need to your service or resource. People get information about your service when calling the National
Hunger Hotline at 1-866-3-HUNGRY (1-866-348-6479) or 1-877-8-HAMBRE (1-877-842-6273). They can
also find your information by searching the USDA National Hunger Clearinghouse online.
Questions with * are required
Organization/government agency name*:
Type of food assistance provided (Mark all that apply):
 Soup kitchen (provides prepared meals (e.g., hot meals or sandwiches)
 Food pantry (provides groceries or ingredients for people to make meals)
 Food bank (does not directly distribute to individuals)
 Summer meals site (place that serves free meals to kids and teens)
 Summer meals grab and go site (place where kids and teens can pick up free meals to go)
 Food truck
 Meal delivery
 Grocery delivery
 Baby formula
 Other
Type of government assistance or application assistance provided (Mark all that apply):
 SNAP
 WIC
 WIC Farmer’s Market Nutrition Program
 SUN Bucks (Summer EBT)
 Summer Meals Programs
 Child and Adult Care Food Program (CACFP)
 Commodity Supplemental Food Program (CSFP) (Seniors)
 Senior Farmer’s Market Nutrition Program
 The Emergency Food Assistance Program
Street address*:
*If the site only does delivery, please put the address of the site’s office.
*If the site does not have a street address (e.g., a food truck) put the cross streets or coordinates.
*If the site has multiple locations, each location should be listed as a separate site.
City*:
State*:
Zip code*:

Phone number (for general public):
Email address (for general public):
Organization website:
What is required to access or prove eligibility for your program? (mark all that apply)
 Photo ID
 Proof of address
 Proof of income
 Must be a senior
Minimum age
 Must be 18 years old or under
 If there are other requirements, please describe:
Service hours*:
Please use 24-hr time. (For example, Monday-Friday, 09:00:00-17:00:00. Saturday 12:00:00-12:30:00)
Service hour additional information:
Is the site handicap accessible?
 Yes
 No
 Unsure
What languages do you offer support in?
 English
 Spanish
 Chinese (Mandarin)
 Chinese (Cantonese)
 Tagalog
 Korean
 Russian
 French
 Other:
Would you like to add anything else?

For internal use only
Please provide employee contact information so we can keep your food assistance information up-todate annually. This information will not be shared with the public.

Primary contact:
Full name*:
Title*:
Email*:
Phone:
Office address:
City:
State:
Zip code:
Alternate contact:
Full name:
Title:
Email:
Phone:
Office address:
City:
State:
Zip code:

This information is being collected to assist the Food and Nutrition Service in providing the public with a
database of nutrition assistance programs and resources available to them. This is a voluntary collection and FNS
uses the information to make sure your nutrition assistance program or resource can be found and accessed by
people in need of food help. 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 control
number. The valid OMB control number for this information collection is 0584-0474. The time required to
complete this information collection is estimated to average 0.067 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, 5th Floor,
Alexandria, VA 22314 ATTN: PRA (0584-0474). Do not return the completed form to this address.