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OMB Control No:	ICR Reference No: 202304-0575-001
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: USDA/RHS	Agency Tracking No:
Title: 7CFR 1910 B & C-Federal Debt and Employment Verification Compliance Common Forms
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR: Yes
Type of Review Request: Regular	Date Submitted to OIRA: 10/11/2023

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	2	0
Time Burden (Hours)	4	0
Cost Burden (Dollars)	0	0

ICR Summary of Burden

	Total Request	Change Due to Agency Discretion
Annual Number of Responses	2	2
Annual Time Burden (Hours)	4	4
Annual Cost Burden (Dollars)	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new information collection package for common forms 1910.

Annual Cost to Federal Government:

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

Agency Contact: Lynn Gilbert 202 690-2682 lynn.gilbert@usda.gov