Ams-71

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. (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.								TITLE OF INFORMATION COLLECTION DOCUMENT					OMB NO.
								FarmerFairness.gov USDA/DOJ complaint web portal					0581-0333
													DATE PREPARED
													May 18, 2022
							REPORTS					RECORDS
						FORMS NO (S)	NO. OF	NO OF	TOTAL ANNUAL	HOURS	TOTAL	NO. OF	ANNUAL	RECORD-
SECTION OF	DESCRIPTION					(If "none"	RESPONDENTS	RESPONSES	RESPONSES	PER	HOURS	RECORD-	HOURS PER	KEEPING HOURS
REGS.						so state)		PER	(Col. D x E)	RESPONSE	(Col. F x G)	KEEPERS	RECORD-	(Col. I x J)
								RESPONDENT					KEEPER
(A)	(B)					(C)	(D)	(E)	(F)	(G)	(H)	(I)	(J)	(K)
201.95	General Complaint					PSD-5001	110	1.0000	110.00	1.5000	165.00
									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		0.00			0.00
									0.00		0.00			0.00
									0.00		0.00			0.00
	SUBTOTAL								110.00		165.00			0.00
	TOTAL OF ALL PAGES								110.00		165.00	0.00		0.00
TOTAL - COLUMNS "F" AND "I" = OMB 831, 13 b; COLUMNS "H" AND "K" = OMB 831, 13c									110.00		165.00