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USDA Forest Service oMB 0596-0217 <br />FS-1500-19 <br />12. G&A REVIEW <br />12. A. The authority and format of this modification (19-LE-1f 061700-009-Ml) have been reviewed and <br />approved for signature by: <br />Diqitally signed by AMY <br />AMY VER E llf [\ veieLLrr'r <br />Date: 2020.01.1 3 1 8:04:29 -08'00' <br />AMY D. VERELLEN <br />U .S. Forest Service Grants Management Specialist <br />12. B. DATE <br />SIGNED <br />Burden Slalement <br />etc.) should contact USDA's TARGET Center at 202-720-2600 {voice and TDD). <br />userscancontactUSDAthroughlocalrelayortheFederalrelayat(800)877-8339(TDD)or(866)377-8642(relayvoice), USDAisanequalopportunityproviderandemployer.