AMS-71 Grid

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.
								Farmers Market Questionnaire					0581-0169
													DATE PREPARED
													18 March, 2009
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT
												RECORDS
														TOTAL
						FORMS NO (S)	NO. OF	NO OF	TOTAL ANNUAL	Hours	TOTAL	NO. OF	ANNUAL	RECORD-
SECTION OF	DESCRIPTION					(If "none"	RESPONDENTS	RESPONSES	RESPONSES	Per	HOURS	RECORD-	HOURS PER	KEEPING HOURS
REGS.						so state)		PER	(Col. D x E)	Response	(Col. F x G)	KEEPERS	RECORD-	(Col. I x J)
								RESPONDENT					KEEPER
(A)	(B)					(C)	(D)	(E)	(F)	(G)	(H)	(I)	(J)	(K)
7 USC 1621 - 1627	Farmers Market Questionnaire (long form)							0.0000	0.00	0.000	0.00			0.00
	Respondents					TM - 6	1,640	0.5000	820.00	0.317	259.67			0.00
	Non-respondents (long form)					none	3,045	0.5000	1,522.50	0.033	50.74			0.00
	Response bias survey (short form)							0.0000	0.00	0.000	0.00			0.00
	Respondents					none	480	0.5000	240.00	0.083	20.00			0.00
	Non- respondents to response bias survey					none	1,520	0.5000	760.00	0.033	25.33			0.00
									0.00		0.00			0.00
									0.00		0.00			0.00
	SUBTOTAL								3,342.50		355.74	0.00		0.00
	TOTAL OF ALL PAGES						0.00		3,342.50		355.74	0.00		0.00
TOTAL - COLUMNS "F" AND "I" = OMB 831, 13 b; COLUMNS "G" AND "K" = OMB 831, 13c									3,342.50		356