View RCF  - OIRA Conclusion

202503-0570-006CF
Historical Inactive 07/31/2025
USDA/RBS 0570-0075
0575-0201 202111-0575-001
RD Form 400-4, Assurance Agreement
RCF New
This form is executed by the grantee and outlines the activities they will undertake to ensure compliance with Title VI of the Civil Rights Act of 1964, 7 CFR part 15, and RBCS regulations. OMB No. 0575-0201 OMB No package requesting use of form 0570-0075
None
 
Katherine Mathis 202 713-7565 katherine.mathis@usda.gov

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Assurance Agreement 10 3 0 Form Form RD 400-4 Assurance Agreement

  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 10 0 0 10 0 0
Annual Time Burden (Hours) 3 0 0 3 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0

Yes
Miscellaneous Actions
No
The agency is requesting to use the form which will result in a program change of 3 burden hours.