This form is available electronically. |
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FSA-85-1 U.S. Department of Agriculture (03-26-03) Farm Service Agency
Reporting and Recordkeeping Requirements
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1. OMB No. |
0560-0165 |
2. Title of Clearance |
7 CFR 785 Certified State Mediation Program |
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3.
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4.
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5.
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6.
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7.
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Annual Burden on the Public (Col. 8 x 9=10 and Col. 10 x 11=12) |
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Description (Title of Form, Report or Record) |
Report
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Record
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Form No.
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Regulation Part/Sec. |
8.
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9.
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10.
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11.
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12. Total Burden Hours |
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No. of Respondents |
No. of Reports Filed Per Person |
Total Annual Responses |
Average Time to Respond
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Exempt |
Non-Exempt |
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Recertification |
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x |
None Budget analyst |
785.3(b) |
36* |
1 |
36 |
2 |
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72 |
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Annual Report |
x |
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None Sec./adm.assist |
785.8(a) |
36 |
1 |
36 |
4 |
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144 |
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Mid-year report |
x |
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None Sec./adm.assist |
785.8(b) |
36 |
1 |
36 |
1 |
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36 |
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Request for Advance or Reimbursement |
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x |
SF 270 OMB#0348-0004 Budget analyst |
785.4 |
36 |
3 |
108 |
1 |
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108 |
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Application for Federal Assistance** |
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x |
SF 424 OMB#4040-0004 |
785.4(b) |
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Budget Information non-construction+ |
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X |
SF-424A OMB#4040-0006 |
785.4 |
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Assurances-Non-Construction** |
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x |
SF 424-B OMB#4040-0007 |
785.4 |
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Financial Status Report*** |
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x |
SF 425 OMB#0348-0061 |
785.4 |
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*Denotes unduplicated respondents |
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**Collection is included in recertification request |
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***Collection is included in annual report |
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+Collection included in annual report and recertification |
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TOTALS |
144 |
6 |
216 |
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360 |
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| File Type | application/msword |
| File Title | This form is available electronically |
| Author | USDA-MDIOL00000DG8C |
| Last Modified By | PDEED |
| File Modified | 2014-07-10 |
| File Created | 2014-03-26 |