Information Collection

7CFR 1910 B & C-Federal Debt and Employment Verification Compliance Common Forms

IC 259656 under ICR 202304-0575-001 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form RD 1910-11 7CFR 1910 B & C-Federal Debt and Employment Verification Compliance Common Forms	Form and Instruction
RD 1910-11 Applicant Certification Federal Collection Policies for RD 1910-11.pdf	Form and Instruction
RD 1910-5 Request for Verification for Employment RD 1910-5 edit.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? Yes

IC Status: New

Obligation to Respond: Voluntary

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 and Instruction	RD 1910-11	Applicant Certification Federal Collection Policies for Consumer and Commercial Debt	RD 1910-11.pdf		Yes	Yes	Fillable Printable
Form and Instruction	RD 1910-5	Request for Verification for Employment	RD 1910-5 edit.pdf		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records

Title: USDA/RDâ1 Current or Prospective Producers or Landowners, Applicants, Borrowers, Grantees, Tenants, and other participants in RD programs

FR Citation: 84 FR 21315

Number of Respondents: 1

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2	2
Annual IC Time Burden (Hours)	4	4
Annual IC Cost Burden (Dollars)	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.