Information Collection

State

IC 273525 under ICR 202501-0579-001 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form NASS ADM-043 Certification and Restrictions on Use of Unpublished Data State	Form
Form NASS ADM-044 User Attestation Form State	Form
Form NASS ADM-045 Site Inspection Checklist State	Form
NAHMS Agent Agreement (20250113).docx	Other-Agreement
NAHMS Agent Agreement (20250113).docx	Other-Agreement
NAHMS Site Inspection Checklist (20250113).docx	Other-Checklist
NAHMS Site Inspection Checklist (20250113).docx	Other-Checklist
NASS ADM-043 Certification and Restrictions on Use of Unpublished Dat NASS ADM-043, Certification and Restrictions on Use of Unpublished Data.pdf	Form
NASS ADM-043 Certification and Restrictions on Use of Unpublished Dat NASS ADM-043, Certification and Restrictions on Use of Unpublished Data.pdf	Form
NASS ADM-044 User Attestation Form NASS ADM-044, User Attestation Form.pdf	Form
NASS ADM-044 User Attestation Form NASS ADM-044, User Attestation Form.pdf	Form
NASS ADM-045 Site Inspection Checklist NASS ADM-045, Site Inspection Checklist.pdf	Form
NASS ADM-045 Site Inspection Checklist NASS ADM-045, Site Inspection Checklist.pdf	Form
NAHMS SAP Data Security Requirements - Index of ICR and Supplemental Materials.docx NAHMS SAP Data Security Requirements Index of ICR and Supplemental Materials	IC Document
NAHMS SAP Data Security Requirements - Index of ICR and Supplemental Materials.docx NAHMS SAP Data Security Requirements Index of ICR and Supplemental Materials	IC Document

IC Title:

State

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Agreement		Yes	Yes	Fillable Fileable Signable
Other-Checklist		Yes	Yes	Fillable Fileable Signable
Form	NASS ADM-043	Yes	Yes	Fillable Fileable Signable
Form	NASS ADM-044	Yes	Yes	Fillable Fileable Signable
Form	NASS ADM-045	Yes	Yes	Fillable Fileable Signable

Line of Business: Natural Resources

Subfunction: Agricultural Innovation and Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	52	52
Annual IC Time Burden (Hours)	26	26
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
NAHMS SAP Data Security Requirements Index of ICR and Supplemental Materials		01/06/2025

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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