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["                                                                    USDA - RUS",null,"Title  of  Information  Document",{"$nulls":5},"OMB  No."]
[null,null,"New Form 395 - Equipment Contract for Telecommunications ",{"$nulls":6},"0572-NEW"]
[" SUMMARY  OF  INFORMATION  COLLECTION",null,"and Broadband Borrowers ",{"$nulls":5},"Date  Prepared"]
[{"$nulls":8},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  RECORDKEEPING  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)"]
[]
[{"$nulls":8}," "," "," "]
[]
[1753,"Equipment Contract  ",395,279,1,279,1.5,418.5]
["Subpart E, H"]
[]
["1753.3 and 6","Borrower's non-conformance request letter ","Written",5,1,5,1,5]
["Subpart A","(construction, design, materials, equipment, etc..)"]
[]
["1753.37, 38,","Certificate of Completion, Equipment Contract ","395a",211,1,211,0.5,105.5]
["39, 68","(Including Installation)"]
[]
["1753.37, 38,","Certificate of Completion, Equipment Contract ","395b",68,1,68,0.5,34]
["39, 68","(Not Including Installation)"]
[]
["1753.37, 38,","Certificate of Contractor and Indemnity Agreement ","395c",211,1,211,0.5,105.5]
["39, 68","(Use only for installation contracts)"]
[]
["1753.37, 38,","Report in writing, including all measurements, any ","395d",211,1,211,0.75,158.25]
["39, 68","acceptance test report and other information required under "]
[null," Part II of applicable specifications"]
[]
[1753,"Certification Regarding Debarment, Suspension, Ineligibility","AD1048",211,1,211,0.25,52.75]
["Subpart E, H","and Voluntary Exclusion - Lower Tier Covered Transactions"]
[]
[1753,"Lobbying Certification (Telephone Version 3, 8/11)","Written",211,1,211,0.05,10.55]
["Subpart E, H",{"$nulls":4}," "]
[]
[null,"TOTALS",null,null,null,1407,null,890]
[null,"FORMS APPROVED UNDER OTHER OMB NUMBERS"]
[]
[1753,"Certificate (\"Buy American\")",213,279,1,279,0.016,4.464]
[null,null,"0572-0107",null,null," ",null," "]
[]
["1753.11,","Construction or Equipment Contract Amendment",238,10,1,10,0.016,0.16]
["28, 38, 68",null,"0572-0107"]
[]
[]
["1784.20(b)(7)","Disclosure of Lobbying Acitivities","SF LLL",1,1,1,0.25,0.25]
[null,null,"(0348-0046)"]
[null,"Total burden associated with OTHER packages",null,279,1,290,0.02,4.78,null,null,"Page 2"]
[null,"Total burden hours associated with THIS package",null,null,null,1407,null,890]
[null,"COMBINED burden associated with this package ",null,null,null,1697,null,895]

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