View Information Collection (IC)
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ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Program Discrimination Complaint Form (Individuals)
Agency IC Tracking Number:
Is this a Common Form?
Yes
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
7 CFR 15.6
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
AD 3027 FRA
USDA Program Discrimination Complaint Form
AD-3027-v7-July-31-2024-Draft_FR_Remediated-FRA.pdf
Yes
No
Fillable Printable
Form and Instruction
AD 3027 ENG
USDA Program Discrimination Complaint Form
AD-3027-v7-July-31-2024-Draft_EN_Fillable_Remediated.pdf
Yes
No
Fillable Printable
Form and Instruction
AD 3027 SPA
USDA Program Complaint Discrimination Form
ad-3027s Dec 5 2024.pdf
No
Fillable Printable
Form and Instruction
AD 3027 ARA
USDA Program Complaint Discrimination Form
AD-3027-v7-July-31-2024-Draft_ARA_Fillable_Remediated-ARA.pdf
Yes
Yes
Fillable Printable
Form and Instruction
AD 3027 HEB
USDA Program Complaint Discrimination Form
AD-3027-v7-July-31-2024-Draft_HEB_Fillable_Remediated-HEB.pdf
Yes
Yes
Fillable Printable
Form and Instruction
AD 3027 KOR
USDA Program Complaint Discrimination Form
AD-3027-v7-July-31-2024-Draft_KOR_Fillable_Remediated-KOR.pdf
Yes
Yes
Fillable Printable
Form and Instruction
AD 3027 Simplified Chinese
USDA Program Discrimination Complaint Form
AD-3027-v7-July-31-2024-Draft_ZHO_Fillable_Remediated-CHIS.pdf
Yes
Yes
Fillable Printable
Form and Instruction
AD 3027 URD
USDA Program Discrimination Complaint Form
AD-3027-v7-July-31-2024-Draft_URD_Fillable_Remediated-URD.pdf
Yes
Yes
Fillable Printable
Form and Instruction
AD 3027 VIE
USDA Program Complaint Discrimination Form
AD-3027-v7-July-31-2024-Draft_VIE_Fillable_Remediated-VIE.pdf
Yes
Yes
Fillable Printable
Form and Instruction
AD 3027 YID
USDA Program Discrimination Complaint Form
AD-3027-v7-July-31-2024-Draft_YID_Fillable_Remediated-YID.pdf
Yes
Yes
Fillable Printable
Form and Instruction
AD 3027TAG
USDA Program Complaint Discrimination Form
AD-3027-v7-July-31-2024-Draft_TGL_Fillable_Remediated-TAG.pdf
Yes
Yes
Fillable Printable
Form and Instruction
AD 3027 PUN
USDA Program Discrimination Complaint Form
AD-3027-v7-July-31-2024-Draft_PAN_Fillable_Remediated-PUN.pdf
Yes
Yes
Fillable Printable
Form and Instruction
AD 3027 GER
USDA Program Discrimination Complaint Form
AD-3027-v7-July-31-2024-Draft_DE_Remediated-GER.pdf
Yes
Yes
Fillable Printable
Form and Instruction
AD 3027 CHIT
USDA Program Discrimination Complaint Form
AD-3027-v7-July-31-2024-Draft_TC_Remediated-CHIT.pdf
Yes
Yes
Fillable Printable
Form and Instruction
AD 3027 HTC
USDA Program Discrimination Complaint Form
AD-3027-v7-July-31-2024-Draft_HT_Remediated-HTC.pdf
Yes
Yes
Fillable Printable
Form and Instruction
AD 3027 ITA
USDA Program Discrimination Complaint Form
AD-3027-v7-July-31-2024-Draft_IT_Remediated-ITA.pdf
Yes
Yes
Fillable Printable
Form and Instruction
AD 3027 JAPANESE
USDA Program Discrimination Complaint Form
AD-3027-v7-July-31-2024-Draft_JA_Remediated-JAP.pdf
Yes
Yes
Fillable Printable
Form and Instruction
AD 3027 POL
USDA Program Discrimination Complaint Form
AD-3027-v7-July-31-2024-Draft_PL_Remediated-POL.pdf
Yes
Yes
Fillable Printable
Form and Instruction
AD 3027 POL
USDA Program Discrimination Complaint Form
AD-3027-v7-July-31-2024-Draft_PT_Remediated-POR.pdf
Yes
Yes
Fillable Printable
Form and Instruction
AD 3027 RUS
USDA Program Discrimination Complaint Form
AD-3027-v7-July-31-2024-Draft_RU_Remediated-RUS.pdf
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Community and Regional Development
Privacy Act System of Records
Title:
USDA/OASCR-1, Civil Rights Enterprise System, (CRES)
FR Citation:
83 FR 65135
Number of Respondents:
158
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
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
158
0
0
0
0
158
Annual IC Time Burden (Hours)
158
0
0
0
0
158
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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