RUS Form 87, Request for Mail List Data

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 87 RUS Form 87, Request for Mail List Data	Form	Modified	Available
2017-0572-0051 Suppt.Stmnt.07_13_2017mpd(rev.2)Final.doc	Supporting Statement A	Uploaded 2017-07-13	Available
FR 60dayNotice0572-0051.pdf	Supplementary Document	Uploaded 2017-05-15	Available
2017 Spreadsheet 0572-0051_03_09_2017.xls	Supplementary Document	Uploaded 2017-05-15	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
1784	RUS Form 87, Request for Mail List Data	Form	Modified

ICR Details

OMB Control No: 0572-0051	ICR Reference No: 201705-0572-002
Status: Active	Previous ICR Reference No: 201405-0572-001
Agency/Subagency: USDA/RUS	Agency Tracking No:
Title: RUS Form 87, Request for Mail List Data
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/14/2017
	Date Received in OIRA: 07/15/2017
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2020	36 Months From Approved	09/30/2017
Responses	980	0	1,125
Time Burden (Hours)	245	0	281
Cost Burden (Dollars)	0	0	0

---

Abstract: The RUS Form 87, Request for Mail List Data, is used to obtain the names and addresses of RUS Electric and Telecommunications borrowers' officer/board of directors and corporate officials who are authorized to sign official documents, make official representations concerning borrowers operations and management, etc.

---

Authorizing Statute(s): PL: Pub.L. 103 - 345 2(a) and 2(b) Name of Law: Rural Electrification Act of 1936, as amended
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 15179	03/27/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 32316	07/13/2017
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
RUS Form 87, Request for Mail List Data	87	Request for Mail List Data - RUS Form 87

---

ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	980	1,125	0	0	-145	0
Annual Time Burden (Hours)	245	281	0	0	-36	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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: No

Burden Reduction Due to:

Short Statement: During the last collection period, the number of RUS Electric and Telecommunication program borrowers declined by 145 from 1,125 to 980 respondents. This change decreased responses by 145 from 1,125 to 980 and the estimated hour burden was reduced by 36 hours.

---

Annual Cost to Federal Government: $7,330

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]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

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

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

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: 07/15/2017

---