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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},"October, 2017"]
[" 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 (by regulation reference)"]
[]
[null,"Initial Application/Application Processing"]
[]
["1776.2 and RD Inst. 1900-D","Identify Employee Relationship","Written",7,1,7,0.25,1.75]
[1776.5,"Organizational Documents-Evidence of Legal Existence and Authority","Written",7,1,7,0.25,1.75]
[1776.5,"List of Directors and Officers","Written",7,1,7,0.25,1.75]
[1776.5,"Evidence of Tax Exempt Status","Written",7,1,7,0.25,1.75]
["1776.7 (b)","Work Plan (Project Proposal, Work Plan, and Budget Justification)","Written",7,1,7,80,560]
["1776.7(c)","Statement of Experience","Written",7,1,7,4,28]
["1776.9 (d) (1)","Pro-forma Balance Sheet","Written",7,1,7,4,28]
["1776.7 (d) (2)","Prior year Audit / Financial Statement","Written",7,1,7,0.25,1.75]
["1776.7 (d) (3)","Pro-forma Income Statement and Cash Flow ","Written",7,1,7,4,28]
[]
[null,"Post Application"]
[]
["1776.2, 3019.26 and 3052","Annual Audit / Financial Statement","Written",7,1,7,0.25,1.75]
["1776.2 and 3019.51","Project Performance Report","Written"]
[null,"Initial",null,7,4,28,2,56]
[null,"Extension",null,4,4,16,2,32]
["1776.2 and 3019.25","Request written approval of workplan changes","Written",4,1,4,2,8]
[1776.1,"Grant Agreement","Written",7,1,7,2,14]
[]
["1776.2 and 3017.335","Cert. Regarding Debarment, Suspension, and Other Responsibility Matters - Primary Covered Transactions (Cleared under 0505-0027)","AD 1047",7,1,7,0.25,1.75]
["1776.2 and 3017.335","Cert. Regarding Debarment, Suspension, and other Responsibility Matters- Lower Tier Transactions (Cleared under 0505-0027)","AD 1048",7,1,7,0.25,1.75]
["1776.2 and 3021.23","Cert. Regarding Drug-Free Workplace Requirements (Grants) Alternative I - for Grantees Other Than Individuals (Cleared under 0505-0027)","AD 1049",7,1,7,0.25,1.75]
[null,"Total for this Package",null,7,null,146,null,769.75]
[]
[null,"Items Cleared Under Other Packages (by form number)"]
[]
[1776.2,"Equal Opportunity Agreement (Cleared under 0575-0018)","RD 400-1",7,1,7,0.17,1.1900000000000002]
[1776.2,"Assurance Agreement (Cleared under 0575-0018)","RD 400-4",7,1,7,0.25,1.75]
["1776.2 and 3018.11","Disclosure of Lobbying Activities-(Cleared under 4040-0013)","SF-LLL",7,1,7,0.25,1.75]
["1776.2 and 3019.22","Request for Advance or Reimbursement - (Cleared under 4040-0012)","SF 270"]
[null,"Initial",null,7,12,84,1,84]
[null,"Extension",null,4,12,48,1,48]
["1776.7 (a)(1)","Application for Federal Assistance (Cleared under 4040-0004)","SF-424"]
[null,"Initial",null,7,1,7,0.75,5.25]
[null,"Revised",null,7,1,7,0.75,5.25]
["1776.9(a)(2)","Budget Information  -  (Cleared under 4040-0006)","SF-424A"]
[null,"Initial",null,7,1,7,3,21]
[null,"Revised",null,7,1,7,3,21]
["1776.9(a)(3)","Assurances - Non Construction Programs - (Cleared under 4040-0007)","SF-424B",7,1,7,0.25,1.75," "," "," "]
["1776.2 and 3019.52","Federal Financial  Report - (Cleared under 4040-0014)","SF-425"]
[null,"Initial",null,7,4,28,1.5,42]
[null,"Extension",null,4,4,16,1.5,24]
[]
[null,"Total for items cleared unter other Packages",null,7,null,232,null,256.94," "]

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