New Equipment Contract (Form 395) for Telecommunications and Broadband Borrowers

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form AD 1048 Debarment Certificate - Lower Tier Covered	Form	Modified	Repair queued
Form 395d RUS Form 395d - Results Of Equiptment Tests	Form	Modified	Available
Form 395c RUS Form 395c - Certificate of Seller	Form	Modified	Repair queued
Form 395b RUS Form 395b - Certificate of Completion	Form	Modified	Repair queued
Form 395a RUS Form 395a - CERTIFICATE OF COMPLETION	Form	Modified	Repair queued
Form 395 RUS Contract Form 395	Form	Modified	Repair queued
Form 395 New Equipment Contract (RUS Contract Form 395) for Telecommunications and Broadband Borrowers	Form	Modified	Repair queued
dm_3rd_Copy of 2019 - 0572-0149 form 36 (7-13-22).xlsx	Supplementary Document	Uploaded 2022-09-23	Repair queued
dm_3rd_2022 - 0572-0149 Supporting Statement 5-12-22.docx	Supporting Statement A	Uploaded 2022-09-23	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
210082	New Equipment Contract (RUS Contract Form 395) for Telecommunications and Broadband Borrowers	Form	Modified	Debarment Certificate - Lower Tier Covered
210082	New Equipment Contract (RUS Contract Form 395) for Telecommunications and Broadband Borrowers	Form	Modified	RUS Form 395d - Results Of Equiptment Tests
210082	New Equipment Contract (RUS Contract Form 395) for Telecommunications and Broadband Borrowers	Form	Modified	RUS Form 395c - Certificate of Seller
210082	New Equipment Contract (RUS Contract Form 395) for Telecommunications and Broadband Borrowers	Form	Modified	RUS Form 395b - Certificate of Completion
210082	New Equipment Contract (RUS Contract Form 395) for Telecommunications and Broadband Borrowers	Form	Modified	RUS Form 395a - CERTIFICATE OF COMPLETION
210082	New Equipment Contract (RUS Contract Form 395) for Telecommunications and Broadband Borrowers	Form	Modified	RUS Contract Form 395
210082	New Equipment Contract (RUS Contract Form 395) for Telecommunications and Broadband Borrowers	Form	Modified
210082	New Equipment Contract (RUS Contract Form 395) for Telecommunications and Broadband Borrowers	Other-Non Form	Modified

ICR Details

OMB Control No: 0572-0149	ICR Reference No: 202202-0572-003
Status: Active	Previous ICR Reference No: 201907-0572-001
Agency/Subagency: USDA/RUS	Agency Tracking No:
Title: New Equipment Contract (Form 395) for Telecommunications and Broadband Borrowers
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 01/13/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 11/03/2022
Terms of Clearance: In accordance with 5 CFR 1320, the information collection is approved for three years. The agency is required to display the OMB Control Number and inform respondents of its legal significance in accordance with 5 CFR 1320.5(b).

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2028	36 Months From Approved	01/31/2025
Responses	161	0	235
Time Burden (Hours)	114	0	160
Cost Burden (Dollars)	0	0	0

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Abstract: In an effort to improve customer service to the RUS rural borrowers, the Agency has proposed to revise and streamline its current contracts. RUS has and will continue to work with industry groups to obtain their input as to what types of changes the borrowers may want to see made to the contracts.

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Authorizing Statute(s): US Code: 7 USC 901 et seq.,as amended Name of Law: RE Act
  

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:
	87 FR 45082	07/27/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 65732	11/01/2022
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
New Equipment Contract (RUS Contract Form 395) for Telecommunications and Broadband Borrowers	AD 1048, 395c, 395a, 395, 395b, 395d	RUS Contract Form 395 ,   RUS Form 395a - CERTIFICATE OF COMPLETION ,   RUS Form 395b - Certificate of Completion ,   RUS Form 395c - Certificate of Seller ,   RUS Form 395d - Results Of Equiptment Tests ,   Debarment Certificate - Lower Tier Covered

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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	161	235	0	-74	0	0
Annual Time Burden (Hours)	114	160	0	-46	0	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: There has been a slight increase in wages since the last burden package was submitted. A significant decrease in the number of respondents offset this wage increase. The decrease may be attributed to the impact of the Covid-19 pandemic reducing awardees’ ability to pursue the purchase and installation of new equipment. Accordingly, there were significant decreases in funding requests for new equipment.

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Annual Cost to Federal Government: $32,655

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

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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? No

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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: 11/03/2022

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