Form 36 for Public Computer Ctr/Sustainable Adoption Appls

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Overview

Public Computer Centers
Sustainable Adoption

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Sheet 1: Public Computer Centers

USDA - RUS	U.S. Department of Commerce - NTIA							OMB No.
			Broadband Technology Opportunities Program						0572-****
SUMMARY OF INFORMATION COLLECTION			Public Computer Centers					Date Prepared
									June-09
INSTRUCTIONS:		>	(f) TOTAL		(h) TOTAL		(k) TOTAL
Use this form when a single information collection document involves multiple reporting and		>	-	= (e) Average	-	= (g) Average	-	= (j) Average
recordkeeping requirements.		>	(d) TOTAL		(f) TOTAL		(i) TOTAL
IDENTIFICATION OF REPORTING AND RECORDKEEPPING REQUIREMENTS						ANNUAL BURDEN
		FORM			REPORTS				RECORDS
		NO(s)	NO. OF	NO. OF	TOTAL	HOURS	TOTAL	NO. OF	ANNUAL	TOTAL
SECTION OF		(If "none"	RESPON-	RESPONSES	ANNUAL	PER	HOURS	RECORD-	HOURS PER	RECORD-
REGULATIONS	DESCRIPTION	so state)	DENTS	PER	RESPONSES	RESPONSE	(Col. f & g)	KEEPERS	RECORD-	KEEPING
				RESPON-	(Col. d & e)				KEEPER	HOURS
				DENT						(Col. i & j)
(a)	(b)	(c)	(d)	(e)	(f)	(g)	(h)	(i)	(j)	(k)
	Loan Application Submission through Broadband Portal, Step 1	n/a	2,500	1	2,500	52.00	130,000
	Verification Filing Documents, Step 2	n/a	250	1	250	3.00	750
	TOTALS		2,500	1.10	2,750	47.55	130,750	0	130,750	0

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Sheet 2: Sustainable Adoption

USDA - RUS	U.S. Department of Commerce - NTIA							OMB No.
			Broadband Technology Opportunities Program						0572-****
SUMMARY OF INFORMATION COLLECTION			Sustainable Adoption					Date Prepared
									June-09
INSTRUCTIONS:		>	(f) TOTAL		(h) TOTAL		(k) TOTAL
Use this form when a single information collection document involves multiple reporting and		>	-	= (e) Average	-	= (g) Average	-	= (j) Average
recordkeeping requirements		>	(d) TOTAL		(f) TOTAL		(i) TOTAL
IDENTIFICATION OF REPORTING AND RECORDKEEPPING REQUIREMENTS						ANNUAL BURDEN
		FORM			REPORTS				RECORDS
		NO(s)	NO. OF	NO. OF	TOTAL	HOURS	TOTAL	NO. OF	ANNUAL	TOTAL
SECTION OF		(If "none"	RESPON-	RESPONSES	ANNUAL	PER	HOURS	RECORD-	HOURS PER	RECORD-
REGULATIONS	DESCRIPTION	so state)	DENTS	PER	RESPONSES	RESPONSE	(Col. f & g)	KEEPERS	RECORD-	KEEPING
				RESPON-	(Col. d & e)				KEEPER	HOURS
				DENT						(Col. i & j)
(a)	(b)	(c)	(d)	(e)	(f)	(g)	(h)	(i)	(j)	(k)
	Loan Application Submission through Broadband Portal, Step 1	n/a	2,500	1	2,500	26.00	65,000
	Verification Filing Documents, Step 2	n/a	250	1	250	3.00	750
	TOTALS		2,500	1.10	2,750	23.91	65,750	0	65,750	0