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 Current
			Burden Statement and Non-Discrimination Statement: According
			to the Paperwork Reduction Act of 1995, an agency may not conduct
			or sponsor, and a person is not required to respond to a
			collection of information unless it displays a valid OMB
			control number. The valid OMB control number for this information
			collection is 0581-0178. The time required to complete this
			information collection is estimated to average 15 minutes per
 response, including the time for reviewing instructions,
			searching existing data sources, gathering and maintaining the
			data needed, and completing and reviewing the collection of
			information.
 
 The U.S. Department of Agriculture (USDA)
			prohibits discrimination in all its programs and activities on the
			basis of race, color, national origin, age, disability, and where
			applicable, sex, marital status, familial status, parental status,
			religion, sexual orientation, genetic information, political
			beliefs, reprisal, or because all or part of an individual’s
			income is derived from any public assistance program (Not all
			prohibited bases apply to all programs.) Persons with disabilities
			who require alternative means for communication of program
			information (braille, large print, audiotape, etc.) should contact
			USDA’s TARGET Center at (202) 720-2600 (voice and TDD).
 
 To
			file a complaint of discrimination, write to USDA, Director,
			Office of Civil Rights, 1400 Independence Avenue, S.W.,
			Washington, D.C. 20250-9410, or call (800) 795-3272 (voice) or
			(202) 720-6382 (TDD). USDA is an equal opportunity provider and
			employer.
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