View RCF - OIRA Conclusion

Title: RD 400-4, Assurance Agreement (0570-0063)

Type of RCF: RCF New

Description of Agency Usage: All applicants and recipients are required to complete this form to comply with Civil Rights Acts and laws.

Authorizing Statute(s): None

Annual Cost to Federal Government:
Agency Contact: Pamela Bennett 202 720-9639 pamela.bennett@usda.gov

Common Form Information Collections (IC) in this RCF:

IC Title	Status	Responses	Hours	Dollars	Document Type	Form No.	Form Name
Assurance Agreement		92	23	0	Form	Form RD 400-4	Assurance Agreement

RCF Summary of Burden:

	Total Request	Change Due to Agency Discretion
Annual Number of Responses	92	92
Annual Time Burden (Hours)	23	23
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: The agency is requesting to use the form which will result in a program change of 23 burden hours