Highly Erodible Land Conservation and Wetland Conservation (7 CFR Part 12)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form FSA-492 Data Needed for Third party Determinations	Form	Removed	Available
Form CCC-21 Supplement to Uniform Storage Agreement	Form	Removed	Available
Form AD-1069 Good Faith Determination - Wetland Violations	Form	Removed	Available
Form AD-1069 Good Faith Determination - Wetland Violations	Form	Removed	Available
Form AD-1069 Good Faith - Wetland Violations	Form	Removed	Available
Form AD-1069 Good Faith Determination - Wetland Violations	Form	Removed	Available
Form AD-1069 Good Faith Determination - Wetland Activity	Form	Removed	Available
Form AD-1026-D Good Faith Determination - Highly Erodible Land Activity	Form	Removed	Available
Form AD-1068 Good Faith Determination - Highly Erodible Land Activity	Form	Removed	Available
Form AD-1068 Good Faith Determination - Highly Erodible Land Activity	Form	Removed	Available
Form AD-1068 Good Faith Determination - Highly Erodible Land Activity	Form	Removed	Available
Form AD-1068 Good Faith Determination-Highly Erodible Land Activity	Form	Removed	Available
Form AD-1026D Relief from Undue Economic Hardship	Form	Removed	Available
Form AD-1026D Relief from Undue Economic Hardship	Form	Removed	Available
Form AD-1026D Relief from Undue Economic Hardship	Form	Removed	Available
Form AD-1026C Landlord/Landower Exemption	Form	Removed	Available
Form AD-1026C Landlord/Landowner Exemption	Form	Removed	Available
Form AD-1026C Landlord/Landower Exemption	Form	Removed	Available
Form AD-1026B Highly Erobile Land Con. Exemption	Form	Removed	Available
Form AD-1026B Highly Erodible Land Conservation Exemption Request	Form	Removed	Available
Form AD-1026B Highly Erodible Land Con. Exemption Request	Form	Removed	Available
Form AD-1026 Highly Erodible Land Conservation and Wetland Conservation Certificate	Form and Instruction	Removed	Available
Form AD-1069 Good Faith Determination Wetland Activity	Form	Unchanged	Available
Form AD-1068 Good Faith Determinations Highly Erodible Land Activity	Form	Unchanged	Available
Form AD-1026D Relief for Undue Economic Hardship Request Highly Erodible Land Conservation	Form	Unchanged	Available
Form AD-1026C Landlord or Landowner Exemption Request	Form	Unchanged	Available
Form AD-1026B Highjly Erobile Land Conservation Exemption Request	Form	Unchanged	Available
Form AD-1026 Highly Erodible Land Conservation and Wetland	Form	Unchanged	Available
Form AD-1026D Relief from Undue Economic Hardship Request - HELC	Form	Removed	Available
Form AD-1026D Relief from Undue Economic Hardship Requeest - HELC	Form	Removed	Available
Form AD-1026C Landlord/Landowner Exemption	Form	Removed	Available
Form AD-1026C Landlord/Lawnowner Exemption	Form	Removed	Available
Form AD-1026B Highly Erodible Land Conservation Exemption Request	Form	Removed	Available
Form AD-1026B Hilghly Erodible Land Conservation Exemption Request	Form	Removed	Available
Form Good Faith Determi AD-1069	Form	Unchanged	Available
Form AD-1068 Good Faith Determination Highly Erobible Land Activity	Form	Unchanged	Available
Form AD-1026D Relief for Undue Economic Hardship Request Highly Erodible Land Conservation	Form	Unchanged	Available
Form AD-1026C Landlord or Landoweer Exemption Request	Form	Unchanged	Available
Form AD-1026B Highly Erodible Land Conservation Exemption Request	Form	Unchanged	Available
Form AD-1026 Highly Erodible Land Conservation and Wetland Consv.	Form	Unchanged	Available
Form CCC-21 Declaration of Eligibility to Recieve Storage Paymentys Under a CCC Storage Agreement	Form	Unchanged	Available
Form AD-1069 Good Faith Determination - Wetland Activity	Form	Unchanged	Available
Form AD-1068 Good Faith Determination-Highly Erobilible Land Activity	Form	Unchanged	Available
Form FSA-492 Data Needed for Third-party Determinations	Form	Unchanged	Available
Form AD-1026D Relief for Undue Economic Hardship Request Hilghly Erodible Land Conservation	Form	Unchanged	Available
Form AD-1026C Landlord or Landowner Exemption Request	Form	Unchanged	Available
Form AD-1026B Highly Erobile Land Conservation Exemption Request	Form	Unchanged	Available
Form AD-1026 Higly Erodible Land Conservation and Wetland Consv.	Form	Unchanged	Available
Form AD-1068 Good Faith Determination-Highly Erobilble Land Activity	Form	Unchanged	Available
Form FSA-492 Data Needed for Third-party Determinations	Form	Unchanged	Available
Form AD-1026D Relief for Undue Economic Hardship Request Highly Erodible Land Conservation	Form	Unchanged	Available
Form AD-1026C Landlord or Landowner Exemption Request	Form	Unchanged	Available
Form AD-1026B Highly Erobile Land Conservation Exemption Request	Form	Unchanged	Available
Form AD-1026 Highly Erodible Land Conservation and Wetland Conservation	Form	Unchanged	Available
Supporting Statement for 0560-0185.doc	Supporting Statement A	Uploaded 2010-01-11	Available
FSA85-1 Reporting and Recordkeeping Requirements.doc	Supplementary Document	Uploaded 2009-11-04	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
45593	Highly Erodible Land Conservation and Wetland Conservation	Form	Removed	Data Needed for Third party Determinations
45593	Highly Erodible Land Conservation and Wetland Conservation	Instruction	Removed
45592	Highly Erodible Land Conservation and Wetland Conservation	Instruction	Removed
45592	Highly Erodible Land Conservation and Wetland Conservation	Form	Removed	Supplement to Uniform Storage Agreement
45591	Highly Erodible Land Conservation and Wetland Conservatio	Instruction	Removed
45591	Highly Erodible Land Conservation and Wetland Conservatio	Form	Removed	Good Faith Determination - Wetland Violations
45590	Highly Erodible Land Conservation and Wetland Conservation	Instruction	Removed
45590	Highly Erodible Land Conservation and Wetland Conservation	Form	Removed	Good Faith Determination - Wetland Violations
45589	Highly Erodible Land Conservation and Wetland Conservation	Instruction	Removed
45589	Highly Erodible Land Conservation and Wetland Conservation	Form	Removed	Good Faith - Wetland Violations
45588	Highly Erodible Land Conservation and Wetland Conservation	Instruction	Removed
45588	Highly Erodible Land Conservation and Wetland Conservation	Form	Removed	Good Faith Determination - Wetland Violations
45587	Highly Erodible Land Conservation and Wetland Conservation	Instruction	Removed
45587	Highly Erodible Land Conservation and Wetland Conservation	Form	Removed	Good Faith Determination - Wetland Activity
45586	Highly Erodible Land Conservation and Wetland Conservation	Instruction	Removed
45586	Highly Erodible Land Conservation and Wetland Conservation	Form	Removed	Good Faith Determination - Highly Erodible Land Activity
45585	Highly Erodible Land Conservation and Wetland Conservation	Instruction	Removed
45585	Highly Erodible Land Conservation and Wetland Conservation	Form	Removed	Good Faith Determination - Highly Erodible Land Activity
45584	Highly Erodible Land Conservation and Wetland Conservation	Instruction	Removed
45584	Highly Erodible Land Conservation and Wetland Conservation	Form	Removed	Good Faith Determination - Highly Erodible Land Activity
45583	Highly Erodible Land Conservation and Wetland Conservation	Instruction	Removed
45583	Highly Erodible Land Conservation and Wetland Conservation	Form	Removed	Good Faith Determination - Highly Erodible Land Activity
45582	Highly Erodible Land Conservation and Wetland Conservation	Instruction	Removed
45582	Highly Erodible Land Conservation and Wetland Conservation	Form	Removed	Good Faith Determination-Highly Erodible Land Activity
45581	Highly Erodible Land Conservation and Wetland Conservation	Instruction	Removed
45581	Highly Erodible Land Conservation and Wetland Conservation	Form	Removed	Relief from Undue Economic Hardship
45580	Highly Erodible Land Conservation and Wetland Conservation	Instruction	Removed
45580	Highly Erodible Land Conservation and Wetland Conservation	Form	Removed	Relief from Undue Economic Hardship
45579	Highly Erodible Land Conservation and Wetland Conservation	Instruction	Removed
45579	Highly Erodible Land Conservation and Wetland Conservation	Form	Removed	Relief from Undue Economic Hardship
45578	Highly Erodible Land Conservation and Wetland Conservation	Instruction	Removed
45578	Highly Erodible Land Conservation and Wetland Conservation	Form	Removed	Landlord/Landower Exemption
45577	Highly Erodible Land Conservation and Wetland Conservation	Instruction	Removed
45577	Highly Erodible Land Conservation and Wetland Conservation	Form	Removed	Landlord/Landowner Exemption
45576	Highly Erodible Land Conservation and Wetland Conservation	Form	Removed	Landlord/Landower Exemption
45576	Highly Erodible Land Conservation and Wetland Conservation	Instruction	Removed
45566	Highly Erobible Land And Wetland Conservation Certification	Form	Removed	Highly Erobile Land Con. Exemption
45565	Highly Erodible Land And Wetland Conservation Certificate	Form	Removed	Highly Erodible Land Conservation Exemption Request
45564	Highly Erodible Land and Wetland Conservation Exemption Request	Form	Removed	Highly Erodible Land Con. Exemption Request
45563	Highly Erodible and Wetland Conservation Cerficiation	Form and Instruction	Removed	Highly Erodible Land Conservation and Wetland Conservation Certificate
45562	Highly Erodible Land and Wetland Conservation Certification (State, Local or Tribal Government)	Form	Unchanged	Good Faith Determination Wetland Activity
45562	Highly Erodible Land and Wetland Conservation Certification (State, Local or Tribal Government)	Form	Unchanged	Good Faith Determinations Highly Erodible Land Activity
45562	Highly Erodible Land and Wetland Conservation Certification (State, Local or Tribal Government)	Form	Unchanged	Relief for Undue Economic Hardship Request Highly Erodible Land Conservation
45562	Highly Erodible Land and Wetland Conservation Certification (State, Local or Tribal Government)	Form	Unchanged	Landlord or Landowner Exemption Request
45562	Highly Erodible Land and Wetland Conservation Certification (State, Local or Tribal Government)	Form	Unchanged	Highjly Erobile Land Conservation Exemption Request
45562	Highly Erodible Land and Wetland Conservation Certification (State, Local or Tribal Government)	Instruction	Unchanged
45562	Highly Erodible Land and Wetland Conservation Certification (State, Local or Tribal Government)	Form	Unchanged	Highly Erodible Land Conservation and Wetland
45430	Highly Erodible Land Conservation and Wetland Consv.	Instruction	Removed
45430	Highly Erodible Land Conservation and Wetland Consv.	Form	Removed	Relief from Undue Economic Hardship Request - HELC
45429	Highly Erodible Land Conservation and Wetland Conservation	Instruction	Removed
45429	Highly Erodible Land Conservation and Wetland Conservation	Form	Removed	Relief from Undue Economic Hardship Requeest - HELC
45428	Highly Erodible Land Conservation and Wetland Consv.	Instruction	Removed
45428	Highly Erodible Land Conservation and Wetland Consv.	Form	Removed	Landlord/Landowner Exemption
45427	Highly Erodible Land Conservaton and Wetland Cons.	Instruction	Removed
45427	Highly Erodible Land Conservaton and Wetland Cons.	Form	Removed	Landlord/Lawnowner Exemption
45426	Highly Erodible Land Conservation and Wetland Consv.	Instruction	Removed
45426	Highly Erodible Land Conservation and Wetland Consv.	Form	Removed	Highly Erodible Land Conservation Exemption Request
45425	Highly Erodible Land Conservation and Wetland Consv.	Instruction	Removed
45425	Highly Erodible Land Conservation and Wetland Consv.	Form	Removed	Hilghly Erodible Land Conservation Exemption Request
45424	Highly Erodible Land Conservation and Wetland Conservation (Federal Government)	Form	Unchanged	AD-1069
45424	Highly Erodible Land Conservation and Wetland Conservation (Federal Government)	Form	Unchanged	Good Faith Determination Highly Erobible Land Activity
45424	Highly Erodible Land Conservation and Wetland Conservation (Federal Government)	Form	Unchanged	Relief for Undue Economic Hardship Request Highly Erodible Land Conservation
45424	Highly Erodible Land Conservation and Wetland Conservation (Federal Government)	Form	Unchanged	Landlord or Landoweer Exemption Request
45424	Highly Erodible Land Conservation and Wetland Conservation (Federal Government)	Form	Unchanged	Highly Erodible Land Conservation Exemption Request
45424	Highly Erodible Land Conservation and Wetland Conservation (Federal Government)	Instruction	Unchanged
45424	Highly Erodible Land Conservation and Wetland Conservation (Federal Government)	Form	Unchanged	Highly Erodible Land Conservation and Wetland Consv.
45423	Highly Erodible Land Conservation and Wetland Conservation (Private Sector)	Form	Unchanged	Declaration of Eligibility to Recieve Storage Paymentys Under a CCC Storage Agreement
45423	Highly Erodible Land Conservation and Wetland Conservation (Private Sector)	Form	Unchanged	Good Faith Determination - Wetland Activity
45423	Highly Erodible Land Conservation and Wetland Conservation (Private Sector)	Form	Unchanged	Good Faith Determination-Highly Erobilible Land Activity
45423	Highly Erodible Land Conservation and Wetland Conservation (Private Sector)	Form	Unchanged	Data Needed for Third-party Determinations
45423	Highly Erodible Land Conservation and Wetland Conservation (Private Sector)	Form	Unchanged	Relief for Undue Economic Hardship Request Hilghly Erodible Land Conservation
45423	Highly Erodible Land Conservation and Wetland Conservation (Private Sector)	Form	Unchanged	Landlord or Landowner Exemption Request
45423	Highly Erodible Land Conservation and Wetland Conservation (Private Sector)	Form	Unchanged	Highly Erobile Land Conservation Exemption Request
45423	Highly Erodible Land Conservation and Wetland Conservation (Private Sector)	Instruction	Unchanged
45423	Highly Erodible Land Conservation and Wetland Conservation (Private Sector)	Form	Unchanged	Higly Erodible Land Conservation and Wetland Consv.
36857	Highly Erodible Land Conservation and Wetland Conservation (Individuals or Households)	Form	Unchanged	Good Faith Determination-Highly Erobilble Land Activity
36857	Highly Erodible Land Conservation and Wetland Conservation (Individuals or Households)	Form	Unchanged	Data Needed for Third-party Determinations
36857	Highly Erodible Land Conservation and Wetland Conservation (Individuals or Households)	Form	Unchanged	Relief for Undue Economic Hardship Request Highly Erodible Land Conservation
36857	Highly Erodible Land Conservation and Wetland Conservation (Individuals or Households)	Form	Unchanged	Landlord or Landowner Exemption Request
36857	Highly Erodible Land Conservation and Wetland Conservation (Individuals or Households)	Form	Unchanged	Highly Erobile Land Conservation Exemption Request
36857	Highly Erodible Land Conservation and Wetland Conservation (Individuals or Households)	Instruction	Unchanged
36857	Highly Erodible Land Conservation and Wetland Conservation (Individuals or Households)	Form	Unchanged	Highly Erodible Land Conservation and Wetland Conservation

ICR Details

OMB Control No: 0560-0185	ICR Reference No: 201001-0560-001
Status: Historical Inactive	Previous ICR Reference No: 200909-0560-004
Agency/Subagency: USDA/FSA	Agency Tracking No:
Title: Highly Erodible Land Conservation and Wetland Conservation (7 CFR Part 12)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn and continue	Conclusion Date: 03/07/2010
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/11/2010
Terms of Clearance: In accordance with 5 CFR 1320, the information collection request has been withdrawn at the request of the agency.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2010	36 Months From Approved	06/30/2010
Responses	262,788	0	262,788
Time Burden (Hours)	262,346	0	262,346
Cost Burden (Dollars)	0	0	0

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Abstract: This information collection is required to determine eligibility of agricultural producers to receive payments from certain programs, including loans, administered by multiple agencies of the USDA.

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Authorizing Statute(s): PL: Pub.L. 99 - 195 201 Name of Law: Food Security At of 1985
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 35158	07/20/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 215	11/09/2009
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
Highly Erodible Land Conservation and Wetland Conservation (Federal Government)	AD-1026, AD-1026C, AD-1068, AD-1026B, Good Faith Determination Wetland Activity, AD-1026D	Highly Erodible Land Conservation and Wetland Consv. ,   Highly Erodible Land Conservation Exemption Request ,   Landlord or Landoweer Exemption Request ,   Relief for Undue Economic Hardship Request Highly Erodible Land Conservation ,   Good Faith Determination Highly Erobible Land Activity ,   AD-1069
Highly Erodible Land Conservation and Wetland Conservation (Private Sector)	FSA-492, AD-1068, AD-1026C, AD-1026, AD-1026B, AD-1026D, AD-1069, CCC-21	Higly Erodible Land Conservation and Wetland Consv. ,   Highly Erobile Land Conservation Exemption Request ,   Landlord or Landowner Exemption Request ,   Relief for Undue Economic Hardship Request Hilghly Erodible Land Conservation ,   Data Needed for Third-party Determinations ,   Good Faith Determination-Highly Erobilible Land Activity ,   Good Faith Determination - Wetland Activity ,   Declaration of Eligibility to Recieve Storage Paymentys Under a CCC Storage Agreement
Highly Erobible Land And Wetland Conservation Certification	AD-1026B	Highly Erobile Land Con. Exemption
Highly Erodible Land And Wetland Conservation Certificate	AD-1026B	Highly Erodible Land Conservation Exemption Request
Highly Erodible Land Conservation and Wetland Conservatio	AD-1069	Good Faith Determination - Wetland Violations
Highly Erodible Land Conservation and Wetland Conservation	AD-1069	Good Faith - Wetland Violations
Highly Erodible Land Conservation and Wetland Conservation	AD-1069	Good Faith Determination - Wetland Activity
Highly Erodible Land Conservation and Wetland Conservation	AD-1026C	Landlord/Landower Exemption
Highly Erodible Land Conservation and Wetland Conservation	AD-1026D	Relief from Undue Economic Hardship
Highly Erodible Land Conservation and Wetland Conservation	CCC-21	Supplement to Uniform Storage Agreement
Highly Erodible Land Conservation and Wetland Conservation	AD-1069	Good Faith Determination - Wetland Violations
Highly Erodible Land Conservation and Wetland Conservation	AD-1026C	Landlord/Landowner Exemption
Highly Erodible Land Conservation and Wetland Conservation	AD-1068	Good Faith Determination - Highly Erodible Land Activity
Highly Erodible Land Conservation and Wetland Conservation	FSA-492	Data Needed for Third party Determinations
Highly Erodible Land Conservation and Wetland Conservation	AD-1068	Good Faith Determination - Highly Erodible Land Activity
Highly Erodible Land Conservation and Wetland Conservation	AD-1026-D	Good Faith Determination - Highly Erodible Land Activity
Highly Erodible Land Conservation and Wetland Conservation	AD-1069	Good Faith Determination - Wetland Violations
Highly Erodible Land Conservation and Wetland Conservation	AD-1026C	Landlord/Landower Exemption
Highly Erodible Land Conservation and Wetland Conservation	AD-1026D	Relief from Undue Economic Hardship Requeest - HELC
Highly Erodible Land Conservation and Wetland Conservation	AD-1026D	Relief from Undue Economic Hardship
Highly Erodible Land Conservation and Wetland Conservation	AD-1026D	Relief from Undue Economic Hardship
Highly Erodible Land Conservation and Wetland Conservation	AD-1068	Good Faith Determination-Highly Erodible Land Activity
Highly Erodible Land Conservation and Wetland Conservation	AD-1068	Good Faith Determination - Highly Erodible Land Activity
Highly Erodible Land Conservation and Wetland Conservation (Individuals or Households)	AD-1026, AD-1026D, FSA-492, AD-1068, AD-1026C, AD-1026B	Highly Erodible Land Conservation and Wetland Conservation ,   Highly Erobile Land Conservation Exemption Request ,   Landlord or Landowner Exemption Request ,   Relief for Undue Economic Hardship Request Highly Erodible Land Conservation ,   Data Needed for Third-party Determinations ,   Good Faith Determination-Highly Erobilble Land Activity
Highly Erodible Land Conservation and Wetland Consv.	AD-1026B	Hilghly Erodible Land Conservation Exemption Request
Highly Erodible Land Conservation and Wetland Consv.	AD-1026D	Relief from Undue Economic Hardship Request - HELC
Highly Erodible Land Conservation and Wetland Consv.	AD-1026C	Landlord/Landowner Exemption
Highly Erodible Land Conservation and Wetland Consv.	AD-1026B	Highly Erodible Land Conservation Exemption Request
Highly Erodible Land Conservaton and Wetland Cons.	AD-1026C	Landlord/Lawnowner Exemption
Highly Erodible Land and Wetland Conservation Certification (State, Local or Tribal Government)	AD-1026C, AD-1026, AD-1068, AD-1069, AD-1026B, AD-1026D	Highly Erodible Land Conservation and Wetland ,   Highjly Erobile Land Conservation Exemption Request ,   Landlord or Landowner Exemption Request ,   Relief for Undue Economic Hardship Request Highly Erodible Land Conservation ,   Good Faith Determinations Highly Erodible Land Activity ,   Good Faith Determination Wetland Activity
Highly Erodible Land and Wetland Conservation Exemption Request	AD-1026B	Highly Erodible Land Con. Exemption Request
Highly Erodible and Wetland Conservation Cerficiation	AD-1026	Highly Erodible Land Conservation and Wetland Conservation Certificate

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Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: This is a revision due to consolidating and removal of IC's within ROCIS.

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Annual Cost to Federal Government: $1,694,958

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 01/11/2010

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