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USDA. Forest Scrvici.: 0MB 05%-0_ 17 <br />FS-1 ·oo -S,\ <br />The authority and fonnat of this agreement (19-LE-11061700-009) have been reviewed <br />and approved for signature. <br />fda O -~ <br />AMY&RELLEN <br />U.S. Forest Service Grants Management Specialist <br />Burden Statement <br />Accoo!ing to Ille Paperwork Redudion Act of 1995, an agency may not ccndt.'tt or sponsor. and a person is not required to respond to a collection of information <br />un.Tess it d"tsplays a vafld 0MB control number. The valid 0MB control numl:er for this inionnaoon col!ec:icn is 0596-0217. The time requ ired ID complete !his <br />infornlation collection is estimated to average 3 hours per response. indudir.g Ille lime fo r reviewing inslrudions . search ing existing data sources, gathering and <br />maintain ing Ille data needed, and =pleting and reviewing the collection of information. <br />The U.S. Cepanment of Agricu lture (USDA) prohibits discrimination in all its programs ar.d activities on ttie basis of race, color. national origin, age, disability, ar.d <br />whae applicable, sex. marital status, famifial sfatus, parental status, relig icn', sexual orientation , ~lie infonnalion, political be fiels , reprisal, or because all or <br />part of an individuars income is deri',ed from any public assistance. (Not an prohilliled bases apply ii all programs.) Persons with disabilities who require <br />al!ema1ive means for communication of program information (Braille, large print. audiotape, etc.) shotlld contact USDA's TARGET Center at 202-720-2600 (voice <br />anc1moi <br />To file a complaint of <fisc:imination, write USDA, Directer, Office of Ci'ltl Rights, 1400 Independence Avent.<e, SW, Washingkm, DC 20250-9410 or call toB free <br />(a66) 632-9992 (voice). TOO users can contact USDA lhrough local relay or tile Federal relay at (BCO) 877-8339 (TDD) or (866) 377.a642 (relay voice). USDA <br />is an ~ opportunity provider and employer. <br />Page 8 of8