View Information Collection (IC)
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ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
New Equipment Contract (Form 395) for Telecommunications and Broadband Borrowers
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
7 CFR 1755
7 CFR 1753
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
AD 1048
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclsion - Lower Tier Covered Transactions
AD1048-F-01-92.pdf
http://www.ocio.usda.gov/policy-directives-records-forms/forms-management/approved-computer-generated-forms
Yes
No
Fillable Fileable
Form
395
Equipment Contract
Form 395 (Third Party-Rider-09-18-13)1-2-14.docx
http://www.rurdev.usda.gov/UP_ETPW_Forms.html#Telecom
Yes
No
Fillable Fileable
Form
395a
Certificate of Completion (Equipment Contract Including Installation)
Form 395a(04-11-12) (2).docx
http://www.rurdev.usda.gov/UP_ETPW_Forms.html#Telecom
Yes
No
Fillable Fileable
Form
395b
Certificate of COmpletion (Equipment Contract Not Including Installation)
Form 395b(04-11-12) 1-2-14.docx
http://www.rurdev.usda.gov/UP_ETPW_Forms.html#Telecom
Yes
No
Fillable Fileable
Form
395c
Cetificate of Contractor and Indemnity
Form 395c(04-11-12) (2) 1-2-14.docx
http://www.rurdev.usda.gov/UP_ETPW_Forms.html#Telecom
Yes
No
Fillable Fileable
Form
395d
Results of Acceptance Test
Form 395d(04-11-12) 1-2-13.docx
http://www.rurdev.usda.gov/UP_ETPW_Forms.html#Telecom
Yes
No
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Economic Development
Subfunction:
Business and Industry Development
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
279
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
0 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,407
0
1,407
0
0
0
Annual IC Time Burden (Hours)
890
0
890
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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