Program Discrimination Complaint Form (Individuals)

USDA Program Discrimination Complaint Form

OMB: 0508-0002

IC ID: 987

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Program Discrimination Complaint Form (Individuals)
 
No Modified
 
Voluntary
 
7 CFR 15.6

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form N/A USDA Program Discrimination Complaint Form AD3027 Program Discrimination Complaint From (proposed form) 10.04.22.pdf Yes No Fillable Printable
Form AD 3027 Program Discrimination Complaint Form AD3027 ProgDiscriminationComplaint review SPA_20220418_Sec508 v2.pdf Yes No Fillable Printable

Community and Social Services Community and Regional Development

USDA/OASCR-1, Civil Rights Enterprise System, (CRES)  83 FR 65135

158 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 158 0 0 0 0 158
Annual IC Time Burden (Hours) 158 0 0 0 0 158
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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