Information Collection

Form RD 1940-59, Settlement Statement

IC 1945 under ICR 200707-0575-002 · OMB 0575-0088.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form RD 1940-59 Form RD 1940-59, Settlement Statement	Form
RD 1940-59 Settlement Statement RD1940-0059_961000V01.pdf	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 7 CFR 1940.406

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	RD 1940-59	Settlement Statement	RD1940-0059_961000V01.pdf		Yes	No	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 21,134

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	21,134	6,225	14,909
Annual IC Time Burden (Hours)	7,530	75	7,455
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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.