Exhibit M                                                                        (Rev. 06/98)

THE EMERGENCY FOOD ASSISTANCE PROGRAM

REGIONAL OFFICE MONTHLY REPORT

Report Month
And Year

Name of Regional
Office

 

 

Instructions:

Please complete and sign this report following the end of the month. This report must be submitted
to the Food Distribution Unit no later than thirty (30) days following the last day of the report month.
  1.  

Participation Information: Report the total number of households that receive TEFAP food(s) in your
management area during this report month (from the 1st calendar day through the last day of the month).
This total should be computed by adding the participation data received from all TEFAP participating
organizations within your respective management area for the report month.

Total Households Served:
  1.  

Inventory Control/Losses: Please report in full case amounts, the quantity of products distributed/lost, and
on hand during this month. These totals should be computed by adding the inventory control data received
from all TEFAP distributing organizations within your management area for the report month.

Product

Total Cases
Distributed

* Total Cases

Lost

* Total Cases on Hand
At End of Report Month

Applesauce

 

 

 

 

Canned Pork/Beef

 

 

 

 

Cereal

 

 

 

 

Corn

 

 

 

 

Dry Beans

 

 

 

 

Fruit Juice

 

 

 

 

Green Beans

 

 

 

 

Macaroni

 

 

 

 

Peaches

 

 

 

 

Peanut Butter

 

 

 

 

Pears

 

 

 

 

Peas

 

 

 

 

Potatoes

 

 

 

 

Raisins/Figs/Prunes

 

 

 

 

Rice

 

 

 

 

Refried Beans

 

 

 

 

Salmon

 

 

 

 

Tomatoes

 

 

 

 

Other

 

 

 

 

Other

 

 

 

 

Other

 

 

 

 

Other

 

 

 

 

* Please indicate the total losses reported by all organizations. Also report any inventory problems (including organizations that consistently maintain large inventories) or other matters which would require the assistance and/or attention of the Food Distribution Unit.

  1.  

Signature of SRS Regional Director or Designee

Date

This institution is an equal opportunity provider.

8-M