Laserfiche WebLink
USDA, Forcst Scrvice OMB 0596-0217 <br />FS-baa <br />4 1 <br />tl-'2�3 <br />BYAS, Special Agent in Char <br />ge <br />,egion 6 Pacific Nortbwest <br />Theauthn o *tv is agreement (I 9 -LE- 11061700-009) ha-vre been reviewed <br />, and format of th* <br />and approved for signature. <br />AMY D. VERELLEN <br />U.S. Forest Service Grants Management Specialist <br />Burden statement <br />A=dirq b Me Paperwork eWon Act of 1995, an agency my not conduct or sparmor, and a person Is od reqtfired to mspW to a oWdicn of information <br />uffiess 4 displays a vard OMB conW number. The varid OMB conW nurnker for this inbraum cc&x5w is 0596-0217, The *ne required to complete this <br />uwfomiabw edlection is esftatd to average 3 hours per response, incWdkg #w *m for rvAewk9 knkuc6 . seamhirg odsfng data sources, gathering and <br />ne7otaining the data needed, and cwnpWng and mvL*vft the coittfion of inbmation. <br />The U.S. Depaftwt of Agriculture (USDA) pmhibits dWtnhidon in aft its pmgrarns and ac#Wbw on I* basis of raw, color, national origin, age, disaft and <br />*ftm appfica* sm writal atm, familial sWm,, pOMW stahm, re5g**n", somal Oemnta*m, gene W k*mv*n, poMW beefs, repdsal, or bemuse ad or <br />pan of an WMduafs incw* is derOed from any pbfic assistance. (Not ag pmhfted baws 4* b d poogtaw-) Posm with disabifibes who mquire <br />aftemaNe mearts br cmimmicaton of program infomzWn (Braft large pint audbtiq*,, m) shcM wnW USD A!s TARGET Caitr at 202-720-2600 (voice <br />and TDO� <br />To Se a !at. of dbakninaWn. wMe USDA, Director, Office of CW Rights, 1400 Independerte Avm*, SK WasNigion. OC 202%9410 or call tol ftee <br />(M6) 632-9992 (vice). TDD uwm can contact USDA through til relay or ft Federal relay at (80D) 877 -SM O) or (866) 377-8642 (relay voice). USDA <br />is .an equW oWft* pv*ler W emplayer. <br />PaLgre 8 of 8 <br />