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Reporting and Recordkeeping Requirement

ICR 202611-0565-001 · OMB 0565-0003 · Object 174969601.

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application/vnd.openxmlformats-officedocument.spreadsheetml.sheet
Reporting and Recordkeeping Requirement
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2026-03-10
2026-11-10
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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-I:
cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b;
cols. H & K = 13c.

TITLE OF INFORMATION COLLECTION DOCUMENT

OMB NO.

USDA-FPAC-BC SUMMARY OF INFORMATION COLLECTION

DATE PREPARED

(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.

March 10, 2026

ANNUAL BURDEN

IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT

REPORTS

SECTION OF
REGS.

DESCRIPTION

(A)

(B)

Page 1 of 1

0560-0190

FORMS NO (S)
(If "none"
so state)

NO. OF
RESPONDENTS

(C)

(D)

NO OF
RESPONSES
PER

RECORDS

TOTAL ANNUAL
RESPONSES
(Col. D x E)

HOURS
PER
RESPONSE

(F)

(G)

RESPONDENT

TOTAL BURDEN HOURS
(Col. F x G)
(H)
EXEMPT

(E)

RESPONDENT COST
TOTAL

NO. OF
RECORDKEEPERS

NON-EXEMPT

ANNUAL
HOURS PER
RECORD-

(Col. I x J)

COST
PER
HOUR

TOTAL
COST
(Col. H x L)

(K)

(L)

(M)

RECORDKEEPING HOURS

KEEPER
(I)

(J)

Power of Attorney

FSA-211

15,000

1

15,000

0.5000

7,500

$46.75

350,625

Power of Attorney - Signature Continuation Sheet

FSA-211A

1,000

1

1,000

0.2500

250

$46.75

11,688

0

0

SUBTOTAL

16,000

0

7,750

0.00

362,313

TOTAL OF ALL PAGES

16,000

0

7,750

0.00

362,313

TOTAL - COLUMNS "F" AND "I" = OMB 83-I, 13b;
COLUMNS "H" AND "K" = OMB 83-I, 13c

16,000

7,750