AMS-71, pg 2

INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. (D), (F), (H), (I), & (K) should be entered in items 17 & 18 of OMB-83-I. For cols. (E), (F), & (J), the averages of the totals shall be computed, as follows, & then entered on the OMB-83-1. (F) Total/Total = (E) Average (H) Total/(F) Total = (G) Average (K) Total/(I) Total = (J) Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.

TITLE OF INFORMATION COLLECTION DOCUMENT

OMB NO.

Specialty Crop Block Grant Program (SCBGP)

0581-NEW

DATE PREPARED

March 9, 2006

IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT

RECORDS

TOTAL

FORMS NO (S)

NO. OF

NO OF

TOTAL ANNUAL

TOTAL

NO. OF

ANNUAL

RECORD-

SECTION OF

DESCRIPTION

(If "none"

RESPONDENTS

RESPONSES

RESPONSES

HOURS

RECORD-

HOURS PER

KEEPING HOURS

REGS.

so state)

PER

(Col. D x E)

(Col. F x G)

KEEPERS

RECORD-

(Col. I x J)

RESPONDENT

KEEPER

(A)

(B)

(C)

(D)

(E)

(F)

(H)

(I)

(J)

(K)

7 USC 1621 note

Final Performance Report

52

1.0000

52.00

1.5000

78.00

0.00

Audit Report/Executive Summary

52

1.0000

52.00

3.0000

156.00

0.00

Grant Agreement

52

1.0000

52.00

0.0830

4.32

0.00

Request for grant period extension letter

5

1.0000

5.00

0.1700

0.85

0.00

0.00

SUBTOTAL

161.00

239

0.00

0.00

TOTAL OF ALL PAGES

468.00

499.00

0.00

0.00

TOTAL - COLUMNS "F" AND "I" = OMB 831, 13 b; COLUMNS "G" AND "K" = OMB 831, 13c

468.00

499