1901-E Civil Rights Common Forms

Forms and Documents

Document Name	Status
Form Form RD - 400-6 Compliance Statement Form	New
Form Form RD 400-4 Assurance Agreement Form	New
Form Form RD 400-1 Equal Opportunity Agreement Form	New
RD Common Forms - 0575-NEW - 1901 SS Final.docx Supporting Statement A	2021-11-08
CR spreadsheet.xlsx Supplementary Document	2021-11-08

IC Document Collections

IC ID	Document Title	Status
250241	Compliance Statement Form	New
250237	Assurance Agreement Form	New
250236	Equal Opportunity Agreement Form	New

ICR Details

OMB Control No:	ICR Reference No: 202111-0575-001
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: USDA/RHS	Agency Tracking No:
Title: 1901-E Civil Rights Common Forms
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  Yes
Type of Review Request: Regular	Date Submitted to OIRA: 03/01/2022

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	3	0
Time Burden (Hours)	0	0
Cost Burden (Dollars)	0	0

---

Abstract: 7 CFR Part 1901-E implements the following Civil Rights laws, Executive Orders, and regulations, to collect the necessary information and enforce the civil rights requirements of RD’s Federally assisted programs and programs that provide housing. Title VI and Title VIII have overlapping coverage providing protection on the bases of race, color and national origin.

---

Authorizing Statute(s): US Code: 42 USC 2000d Name of Law: Prohibition against exclusion from participation in, denial of benefits of, and discrimination unde
   US Code: 42 USC 2000e-5 Name of Law: THE PUBLIC HEALTH AND WELFARE
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 61116	11/05/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 9564	02/22/2022
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 3

IC Title	Form No.	Form Name
Assurance Agreement	Form RD 400-4	Assurance Agreement
Compliance Statement	Form RD - 400-6	Compliance Statement
Equal Opportunity Agreement	Form RD 400-1	Equal Opportunity Agreement

---

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	3	0	0	3	0	0
Annual Time Burden (Hours)	0	0	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

---

Common Form ICR:  Yes

Description/Changes for Common Form Usage:  The Agencies are required to provide Federal financial assistance through its housing and community and business programs on an equal opportunity basis. The laws implemented in 7 CFR part 1901, subpart E, require the recipients of RD Federal financial assistance to collect various types of information, including information on participants in certain of these agencies’ programs, by race, color, and national origin.

Approved RCFs using this ICR

Agency/Sub Agency	RCF ID	RCF Title	RCF Status	IC Title

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 03/01/2022

---