Information Collection

Telecommunications Field Trials

IC 1878 under ICR 200902-0572-002 · OMB 0572-0133.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Form 399a Telecommunications Field Trials	Form
Form 399b Telecommunications Equipment Field Trial rus0399b.pdf www.usda.gov/rus/telecom/publications/forms-b.htm	Form
Form 399a supplemental Agreement to Equipment Contract for Field T rus0399A.pdf www.usda.gov/rus/telecom/publications/forms-a.htm	Form
Form 399 Supplemental Agreement to Equipment Contract for Field T rus0399.pdf www.usda.gov/rus/telecom/publications/form-399.htm	Form and Instruction

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:

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	Form 399a	supplemental Agreement to Equipment Contract for Field Trial	rus0399A.pdf	http://www.usda.gov/rus/telecom/publications/forms-a.htm	Yes	No	Fillable Fileable
Form and Instruction	Form 399	Supplemental Agreement to Equipment Contract for Field Trial	rus0399.pdf	http://www.usda.gov/rus/telecom/publications/form-399.htm	Yes	No	Fillable Fileable
Form	Form 399b	Telecommunications Equipment Field Trial	rus0399b.pdf	http://www.usda.gov/rus/telecom/publications/forms-b.htm	Yes	No	Fillable Fileable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 14

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	112	94	18
Annual IC Time Burden (Hours)	371	317	54
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.