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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",null,"7 CFR 1776 Household Water System Program",{"$nulls":5},"Date  Prepared"]
[{"$nulls":9},"2007-09-12"]
[" 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",10,1,10,4,40]
[]
["Application Guide","Project Proposal","Written",10,1,10,40,400]
[]
["7 CFR Part 1776.7(b)","Work Plan (scope of work)","Written",10,1,10,5,50]
[]
["Application Guide","Budget Justification","Written",10,1,10,1,10]
[]
["7 CFR Part 1776.7(d)","Prior year Audit / Financial Statement","Written",10,1,10,3,30]
[]
["7 CFR Part 1776.9(d)","Pro-forma Balance Sheet and Financial Statements","Written",10,1,10,10,100]
[]
["Application Guide","Organizational Documents-Evidence of Legal Existence and Authority","Written",10,1,10,0.25,2.5]
[]
["Application Guide","List of Directors and Officers","Written",10,1,10,0.25,2.5]
[]
["Application Guide","Evidence of Tax Exempt Status","Written",10,1,10,0.25,2.5]
[]
["RD Instruction 1900-D","Identify Employee Relationship","Written",10,1,10,0.17,1.7000000000000002]
[]
["7 CFR Part  3018.110 & Application Guide","Certification Regarding Lobbying","Written",10,1,10,0.17,1.7000000000000002]
[]
["7 CFR Part 3017.335 & Application Guide","Debarment and Suspension Information","Written",10,1,10,0.25,2.5]
[]
["7 CFR  Part 3021.230 & Application Guide","Drug-Free Workplace Requirements","Written",10,1,10,0.25,2.5]
[]
["Executive Order 13166","Limited English Proficiency","Written",10,1,10,1.5,15]
[]
[]
["7 CFR Part 1776.1","Grant Agreement","Written",5,1,5,2,10]
[]
["7 CFR Part 3019.26 and 7 CFR Part 3052","Annual Audit / Financial Statement","Written",5,1,5,40,200]
[]
["7 CFR Part 3019.25","Request written approval of workplan changes","Written",5,1,5,0.25,1.25]
[]
["7 CFR Part 3019.51 ","Project Performance Report","Written",5,4,20,12,240]
[]
[null,"Total Items Cleared Under This Package",null,10,null,175,null,1112.15]
[]
[null,"Items Cleared Under Other Packages"]
[{"$nulls":8}," "," "," "]
["7 CFR Part 1776.9(a)(1)","Application for Federal Assistance","SF-424",10,1,10,0.75,7.5," "," "," "]
[null,null,"(0348-0043 &"]
[null,null,"4040-0004)"]
["7 CFR Part  1776.9(a)(2)","Budget Information","SF-424A",10,1,10,3,30]
[null,null,"(0348-0044&"]
[null,null,"4040-0006)"]
["7 CFR Part  1776.9(a)(3)","Assurances - Non Construction Programs","SF-424B",10,1,10,0.25,2.5," "," "," "]
[null,null,"(0348-0040 &"]
[null,null,"4040-0007)"]
["7 CFR Part 3018.110 & Application Guide","Disclosure of Lobbying Activities","SF-LLL",5,1,5,0.17,0.8500000000000001]
[null,null,"(0348-0038)"]
[]
["Application Guide","Equal Opportunity Agreement","RD 400-1",5,1,5,0.17,0.8500000000000001]
[null,null,"(0575-0018)"]
[]
["Application Guide","Assurance Agreement","RD 400-4",5,1,5,0.25,1.25]
[null,null,"(0575-0018)"]
[]
["7 CFR Part 3019.22","Request for Advance or Reimbursement","SF 270",5,12,60,1,60]
[null,null,"(0348-0004)"]
[]
["7 CFR Part 3019.52","Financial Status Report (Short Form)","SF 269A",37,4,148,1.5,222]
[null,null,"(0348-0038)"]
[{"$nulls":8}," "]

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