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is USDA, Forest Service OMB 0596-0217 <br />FS-1500-8 <br />Burden Statement <br />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 <br />unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0596-0217. The time required to complete this <br />information collection is estimated to average 3 hours per response, including 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 />In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and <br />employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, religion, sex, <br />gender identity (including gender expression), sexual orientation, disability, age, marital status, family/parental status, income derived from a public assistance <br />program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity conducted or funded by USDA (not all bases apply to all <br />programs). Remedies and complaint filing deadlines vary by program or incident. <br />Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign language, <br />etc.) should contact the responsible Agency or USDA's TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service <br />at (800) 877-8339. Additionally, program information may be made available in languages other than English. <br />To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at How to File a Program <br />Discrimination Complaint and at any USDA office or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To <br />request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by: (1) mail: U.S. Department of Agriculture, Office of the <br />Assistant Secretary for Civil Rights, 1400 Independence Avenue, SW, Washington, D.C. 20250.9410; (2) fax: (202) 690-7442; or (3) email: <br />program.intake@usda.gov. USDA is an equal opportunity provider, employer, and lender. <br />(Rev. 9-15) <br />Page 10 of 19 <br />