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["                                                                    USDA - RUS",null,"Title  of  Information  Document",{"$nulls":5},"OMB  No."]
[null,null," ",{"$nulls":6},"0572-0139"]
[" SUMMARY  OF  INFORMATION  COLLECTION",{"$nulls":7},"Date  Prepared"]
[null,"7 CFR 1776 Household Water System Program",{"$nulls":7},2014]
[" INSTRUCTIONS:"," ",null,null,">","(f)  TOTAL",null,"(h)  TOTAL",null,"(k)  TOTAL"]
["Use this form when a single information collection document involves multiple reporting and                  ",null,null,null,">","-","= (e)  Average","-","= (g)  Average","-","= (j)  Average"]
["  recordkeeping requirements.  ",null,null,null,">","(d)  TOTAL",null,"(f)  TOTAL",null,"(i)  TOTAL"]
["         IDENTIFICATION  OF  REPORTING  AND  RECORDKEEPPING  REQUIREMENTS",{"$nulls":5},"ANNUAL  BURDEN"]
[null,null,"FORM",null,null,"REPORTS",null,null,null,"RECORDS"]
[null,null,"NO(s)","NO.  OF","NO.  OF","TOTAL","HOURS","TOTAL","NO.  OF","ANNUAL","TOTAL"]
["SECTION  OF",null,"(If  \"none\"","RESPON-","RESPONSES","ANNUAL","PER","HOURS","RECORD-","HOURS  PER","RECORD-"]
["REGULATIONS","DESCRIPTION","so  state)","DENTS","PER","RESPONSES","RESPONSE","(Col.  f  &  g)","KEEPERS","RECORD-","KEEPING"]
[{"$nulls":4},"RESPON-","(Col.  d  &  e)",null,null,null,"KEEPER","HOURS"]
[{"$nulls":4},"DENT",{"$nulls":5},"(Col.  i  &  j)"]
["(a)","(b)","(c)","(d)","(e)","(f)","(g)","(h)","(i)","(j)","(k)"]
[null,"Items Cleared With This Package"]
["7 CFR Part1776.7(c)","Statement of Experience","Written",7,1,7,4,28]
["Application Guide","Project Proposal","Written",7,1,7,72,504]
["7 CFR Part 1776.7(b)","Work Plan (scope of work)","Written",7,1,7,8,56]
["Application Guide","Budget Justification","Written",7,1,7,4,28]
["7 CFR Part 1776.7(d)","Prior year Audit / Financial Statement","Written",7,1,7,0.25,1.75]
["7 CFR Part 1776.9(d)","Pro-forma Balance Sheet and Financial Statements","Written",7,1,7,5,35]
["Application Guide","Organizational Documents-Evidence of Legal Existence and Authority","Written",7,1,7,0.5,3.5]
["Application Guide","List of Directors and Officers","Written",7,1,7,0.25,1.75]
["Application Guide","Evidence of Tax Exempt Status","Written",7,1,7,0.25,1.75]
["RD Instruction 1900-D","Identify Employee Relationship","Written",7,1,7,1,7]
["7 CFR Part  3018.110 & Application Guide","Certification Regarding Lobbying","Written",7,1,7,0.08,0.56]
["7 CFR Part 3017.335 & Application Guide","Debarment and Suspension Information","Written",7,1,7,0.42,2.94]
["7 CFR  Part 3021.230 & Application Guide","Drug-Free Workplace Requirements","Written",7,1,7,0.42,2.94]
["Executive Order 13166","Limited English Proficiency","Written",7,1,7,1,7]
["7 CFR Part 1776.1","Grant Agreement","Written",7,1,7,3,21]
["7 CFR Part 3019.26 and 7 CFR Part 3052","Annual Audit / Financial Statement","Written",7,1,7,0.25,1.75]
["7 CFR Part 3019.25","Request written approval of workplan changes","Written",7,1,7,1,7]
["7 CFR Part 3019.51 ","Project Performance Report","Written",7,4,28,2,56]
["7 CFR Part 1776.9(a)(1)","Application for Federal Assistance (Form approved under 4040-0004","SF-424",7,1,7,1,7]
["Application Guide","Assurance Agreement (Form approved under 0575-0018)","RD 400-4",7,1,7,0.25,1.75]
["Application Guide","Equal Opportunity Agreement (Form approved under 0575-0018)","RD 400-1",7,1,7,0.25,1.75]
[null,"Total for this Package",null,7,null,168,null,776.44]
[null,"Items Cleared Under Other Packages"]
["7 CFR Part  1776.9(a)(2)","Budget Information  -  (Cleared under 4040-0006)","SF-424A",7,1,7,1.5,10.5]
["7 CFR Part  1776.9(a)(3)","Assurances - Non Construction Programs - (Cleared under 4040-0007)","SF-424B",7,1,7,0.5,3.5," "," "," "]
["7 CFR Part 3018.110 & Application Guide","Disclosure of Lobbying Activities-(Cleared under 4040-0013)","SF-LLL",7,1,7,0.25,1.75]
["7 CFR Part 3019.22","Request for Advance or Reimbursement - (Cleared under 4040-0012)","SF 270",7,12,84,1,84]
["7 CFR Part 3019.52","Federal Financial  Report - (Cleared under 4040-0014)","SF 425",28,4,112,1.5,168]
[null,"Total for items cleared unter other Packages",null,7,null,217,null,267.75," "]

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