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						THIS
						INFORMATION IS USED TO VERIFY THE PROVISIONS OF THE ORDER, 7
						CFR 932.151 MAKING ANY FALSE STATEMENTS OR REPRESENTATIONS IN
						ANY MATTER WITHIN THE JURISDICTION OF ANY AGENCY OF THE
						UNITED STATES, KNOWING IT TO BE FALSE, IS A VIOLATION OF TITLE
						18 SECTION 1001, UNITED STATES CODE, WHICH PROVIDES FOR PENALTY
						OF A FINE, OR IMPRISONMENT, OR BOTH.
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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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