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USDA. Forest Service <br />Burden Statement <br />OMB 0596-0217 <br />FS·1S()()·8A <br />According to the PapetWork Reduction Ad. of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information <br />unless it displays a valid OMB conlrol number. The valid OMS control number for this information collection is 0596-0217. The time requiled to complete this <br />infomnatioo collection is estimated to average 3 hours per response, incfuding the time for reviewing instructions, searching existing data sources, gathering and <br />maintaining the data needed, and completing and reviewing the collection of information. <br />The U.S, Department of AgriculbJre (USDA) prohibits disaimination in all its programs and activities 011 the basis of race, color, national origin, age, disabiUty, and <br />where appficab!e, sex, marital status. famifial status, parental status, religion, sexual orientation, genetic infonnation, political be6efs, reprisal, 0( because all or <br />part of an individuars income is derived from any public assistance. (Not all prohibited bases apply to all programs,) Persons with disabifities who require <br />a1temative means for communication of program information (Braille, large print audiotape, etc.) should contact USDA's TARGET Center at 202·720-2600 (voice <br />and TOO). <br />To file a complaint of disaimination, write USDA, Director, Office of Civil Rights, 1400 Independence Avenue, SW, Washington, DC 20250·9410 or can totl free <br />(866) 632·9992 (voice). TOD users can contact USDA through local relay or the Federal relay at (800) 877-8339 (TDD) or (866) 377-8642 (relay voice), USDA <br />is an equal opportunity provider and employer. <br />Page 6of6