Information Collection

Representation for CCC and FSA Loans and Authorization to File a Financing Statement

IC 184466 under ICR 202101-0560-003 · OMB 0560-0215.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0560-0215 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CCC-10 Representation for CCC and FSA Loans and Authorization to File a Financing Statement	Form
CCC0010egov_1.docx forms.sc.egov.usda.gov/eforms/formsearchservlet	Instruction
CCC0010egov_1.docx forms.sc.egov.usda.gov/eforms/formsearchservlet	Instruction
CCC-10 Representation for CCC and FSA Loans and Authorization t CCC0010_ 2.docx forms.sc.egov.usda.gov/eforms/mainservlet	Form
CCC-10 Representation for CCC and FSA Loans and Authorization t CCC0010_ 2.docx forms.sc.egov.usda.gov/eforms/mainservlet	Form

IC Title:

Representation for CCC and FSA Loans and Authorization to File a Financing Statement

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	CCC-10	Representation for CCC and FSA Loans and Authorization to File a Financing Statement	CCC0010_ 2.docx	http://forms.sc.egov.usda.gov/eforms/mainservlet	Yes	No	Fillable Fileable
Instruction			CCC0010egov_1.docx	http://forms.sc.egov.usda.gov/eforms/formsearchservlet	Yes	No	Printable Only

Line of Business: Natural Resources

Subfunction: Agricultural Innovation and Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 817

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 4 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	817	-617	1,434
Annual IC Time Burden (Hours)	68	-51	119
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.