View Information Collection (IC)
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Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
New Equipment Contract (RUS Contract Form 395) for Telecommunications and Broadband Borrowers
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
395
RUS Contract Form 395
RUS 395.pdf
http://www.rurdev.usda.gov/UP_ETPW_Forms.html#Telecom
Yes
No
Printable Only
Form
395a
RUS Form 395a - CERTIFICATE OF COMPLETION
Form 395a FINAL.docx
tp://www.rurdev.usda.gov/UP_ETPW_Forms.html#Telecom
Yes
No
Printable Only
Form
395b
RUS Form 395b - Certificate of Completion
RUS 395b.pdf
http://www/rurdev.usda.gov/UP_ETPW_Forms.html#telecom
Yes
No
Printable Only
Form
395c
RUS Form 395c - Certificate of Seller
RUS 395c.pdf
http://www/rurdev.usda.gov/UP_ETPW_Forms.html#Telecom
Yes
No
Printable Only
Form
395d
RUS Form 395d - Results Of Equiptment Tests
RUS 395d.pdf
http://www/rurdev.usda.gov/UP_ETPW_Forms.html#Telecom
Yes
No
Printable Only
Form
AD 1048
Debarment Certificate - Lower Tier Covered
AD-1048 DebarmentCert-LowerTierCovered.pdf
Yes
Yes
Fillable Fileable
Other-Non Form
This is a place holder for the following non-form reporting requirements.docx
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Economic Development
Subfunction:
Business and Industry Development
Privacy Act System of Records
Title:
USDA/RD–1 Current or Prospective Producers or Landowners, Applicants, Borrowers, Grantees, Tenants, and other participants in RD programs.
FR Citation:
87 FR 21315
Number of Respondents:
28
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
100 %
Approved
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
161
0
-74
0
0
235
Annual IC Time Burden (Hours)
114
0
-46
0
0
160
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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