| This form is available electronically. | ||||||||||||||
| FSA-85-1 U.S. Department of Agriculture (03-26-03) Farm Service Agency 
 Reporting and Recordkeeping Requirements 
 
 
 
 | 1. OMB No. | 0560-0146 | 2. Title of Clearance | Debt Settlement Policies and Procedures (April 2012) | ||||||||||
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					 7. 
 | Annual Burden on the Public (Col. 8 x 9=10 and Col. 10 x 11=12) | |||||||||
| Description (Title of Form, Report or Record) | Report 
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 | Regulation Part/Sec. | 
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					 11. 
 | 12. Total Burden Hours | |||||
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					 | No. of Respondents | No. of Reports Filed Per Person | Total Annual Responses | 
					 Average Time to Respond 
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					 Exempt | Non-Exempt | ||||
| Installment Agreement | 
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 | 7CFR792; 7CFR1403 | 100 | 1 | 100 | 30 min | 
 | 50 | ||||
| Financial Statement | 
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 | 7 CFR792; 7CFR1403 | 100 | 1 | 100 | 15 min | 
 | 25 | ||||
| Promissory Note | 
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 | CCC-279 | 7CFR792; 7CFR1403 | 100 | 1 | 100 | 15 min | 
 | 25 | ||||
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 | 100 | ||||
| Travel Time | 
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 | 100 | 
 | 100 | 60 min | 
 | 100 | ||||
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| TOTALS  | 100 | 1 | 300 | 
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 | 200 hrs | ||||||||
	
| File Type | application/msword | 
| File Title | This form is available electronically | 
| Author | USDA-MDIOL00000DG8C | 
| Last Modified By | maryann.ball | 
| File Modified | 2012-05-14 | 
| File Created | 2012-05-14 |