Document
Burden Renewal Spreadsheet
ICR 201501-0505-001 · OMB 0505-0025 · Object 52991401.
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Document Metadata
| File Type | application/encrypted |
|---|---|
| File Title | Burden Renewal Spreadsheet |
| Author | user |
| Last Modified By | Calc |
| File Created | 2026-10-14 |
| Conversion State | complete |
Extracted Text
REPRODUCE LOCALLY. Include form number and date on all reproductions. Page 1 of 6 SUMMARY OF INFORMATION COLLECTION INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-I: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO. Representations Regarding Felony Conviction and Tax Delinquent status 0505-0025 for Corporate Applicants and Awardees in Non-procurement Programs (F)Total/(D)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. DATE PREPARED November 30, 2012 ANNUAL BURDEN IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT REPORTS RECORDS RESPONDENT COST TOTAL SECTION OF REGS. DESCRIPTION (A) (B) FORMS NO (S) (If "none" so state) NO. OF RESPONDENTS (C) (D) NO OF RESPONSES PER TOTAL ANNUAL RESPONSES (Col. D x E) HOURS PER RESPONSE TOTAL HOURS (Col. F x G) NO. OF RECORDKEEPERS (F) (G) (H) (I) RESPONDENT (E) ANNUAL HOURS PER RECORD- (Col. I x J) COST PER HOUR (K) (L) RECORDKEEPING HOURS KEEPER (J) P. L. 112-74, Representations Regarding Felony Conviction & Sec. 433 Tax Delinquent Status for Corporate Applicants AD-3030-FS and 434 110,000 1.75 192,500.00 0.2500 48,125.00 0.00 Assurance Regarding Felony Conviction or Tax Delinquent Status for Corporate Applicants -Awardees 81,400 1.75 142,450.00 0.2500 35,612.50 0.00 0.00 0.00 P.L. 112-55 Sec. 738 and 739 AD3031-FS Representations Regarding Felony Conviction & Tax Delinquent Status for Corporate Applicants 0.00 -- NIFA AD-3030 6,300 1.75 11,025.00 0.2500 2,756.25 0.00 -- FNS AD-3030 720 1.75 1,260.00 0.2500 315.00 0.00 -- APHIS AD-3030 3,066 1.75 5,365.50 0.2500 1,341.38 0.00 -- AMS AD-3030 1,631 1.75 2,854.25 0.2500 713.56 0.00 -- RBS AD-3030 5,864 1.75 10,262.00 0.2500 2,565.50 0.00 -- RHS AD-3030 86,206 1.75 150,860.50 0.2500 37,715.13 0.00 SUBTOTAL 516,577.25 129,144.31 0.00 0.00 TOTAL OF ALL PAGES 2,256,096.50 564,024.13 0.00 0.00 TOTAL - COLUMNS "F" AND "I" = OMB 831, 13 b; COLUMNS "H" AND "K" = OMB 831, 13c 2,256,096.50 564,024.13 APHIS FORM-71 (07-05) Electronic versions designed using Word; InForms; Microsoft Excel by USDA-APHIS. SUMMARY OF INFORMATION COLLECTION USDA-APHIS REPRODUCE LOCALLY. Include form number and date on all reproductions. Page 2 of 6 SUMMARY OF INFORMATION COLLECTION INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO. Representations Regarding Felony Conviction and Tax Delinquent status 0505-0025 for Corporate Applicants and Awardees in Non-procurement Programs (F)Total/(D)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. DATE PREPARED November 30, 2012 ANNUAL BURDEN IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT REPORTS RECORDS RESPONDENT COST TOTAL SECTION OF DESCRIPTION REGS. FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD- (If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS PER PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J) HOUR (F) (G) (H) (I) (K) (L) so state) RESPONDENT (A) (B) (C) (D) (E) KEEPER Representations Regarding Felony Conviction & Tax Delinquent Status for Corporate Applicants -continued P.L. 112-55 Sec. 738 and 739 COST 0.00 (J) 0.00 0.00 -- FAS AD-3030 136,080 1.75 238,140.00 0.2500 59,535.00 0.00 -- NRCS AD-3030 30,000 1.75 52,500.00 0.2500 13,125.00 0.00 -- FSA AD-3030 75,580 1.75 132,265.00 0.2500 33,066.25 -- OCFO AD-3030 286,097 1.75 500,669.75 0.2500 125,167.44 0.00 0.00 0.00 Assurance Regarding Felony Conviction or Tax Delinquent Status for Corporate Applicants -Awardees 0.00 -- NIFA AD-3031 4,500 1.75 7,875.00 0.2500 1,968.75 -- FNS AD-3031 530 1.75 927.50 0.2500 231.88 0.00 -- APHIS AD-3031 2,168 1.75 3,794.00 0.2500 948.50 0.00 -- AMS AD-3031 281 1.75 491.75 0.2500 122.94 0.00 -- RBS AD-3031 4,343 1.75 7,600.25 0.2500 1,900.06 0.00 -- RHS AD-3031 63,792 1.75 111,636.00 0.2500 27,909.00 0.00 -- FAS AD-3031 100,699 1.75 176,223.25 0.2500 44,055.81 0.00 SUBTOTAL APHIS FORM-71 (07-05) Electronic versions designed using Word; InForms; Microsoft Excel by USDA-APHIS. 1,232,122.50 SUMMARY OF INFORMATION COLLECTION 308,030.63 0 0.00 USDA-APHIS REPRODUCE LOCALLY. Include form number and date on all reproductions. Page 3 of 6 SUMMARY OF INFORMATION COLLECTION INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO. Representations Regarding Felony Conviction and Tax Delinquent status 0505-0025 for Corporate Applicants and Awardees in Non-procurement Programs (F)Total/(D)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. DATE PREPARED November 30, 2012 ANNUAL BURDEN IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT REPORTS RECORDS RESPONDENT COST TOTAL SECTION OF DESCRIPTION REGS. FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD- (If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS PER PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J) HOUR (F) (G) (H) (I) (K) (L) so state) RESPONDENT (A) (B) (C) (D) (E) COST KEEPER Assurance Regarding Felony Conviction or Tax Delinquent Status for Corporate Applicants -Awardees -- continued 0.00 (J) 0.00 0.00 -- NRCS AD-3031 22,200 1.75 38,850.00 0.2500 9,712.50 0.00 -- FSA AD-3031 55,929 1.75 97,875.75 0.2500 24,468.94 0.00 -- RMA AD-3031 100 1.75 175.00 0.2500 43.75 -- OCFO AD-3031 211,712 1.75 370,496.00 0.2500 92,624.00 SUBTOTAL APHIS FORM-71 (07-05) Electronic versions designed using Word; InForms; Microsoft Excel by USDA-APHIS. 507,396.75 SUMMARY OF INFORMATION COLLECTION 126,849.19 0.00 0 0.00 USDA-APHIS REPRODUCE LOCALLY. Include form number and date on all reproductions. SUMMARY OF INFORMATION COLLECTION Page 4 of 6 RESPONDENT COST TOTAL COST (Col. H x L) (M) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 APHIS FORM-71 (07-05) Electronic versions designed using Word; InForms; Microsoft Excel by USDA-APHIS. SUMMARY OF INFORMATION COLLECTION USDA-APHIS REPRODUCE LOCALLY. Include form number and date on all reproductions. SUMMARY OF INFORMATION COLLECTION Page 5 of 6 RESPONDENT COST TOTAL COST (Col. H x L) (M) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 APHIS FORM-71 (07-05) Electronic versions designed using Word; InForms; Microsoft Excel by USDA-APHIS. SUMMARY OF INFORMATION COLLECTION USDA-APHIS REPRODUCE LOCALLY. Include form number and date on all reproductions. SUMMARY OF INFORMATION COLLECTION Page 6 of 6 RESPONDENT COST TOTAL COST (Col. H x L) (M) $0.00 $0.00 $0.00 $0.00 $0.00 APHIS FORM-71 (07-05) Electronic versions designed using Word; InForms; Microsoft Excel by USDA-APHIS. SUMMARY OF INFORMATION COLLECTION USDA-APHIS