| USDA - RUS |
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Title of Information Document |
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OMB No. |
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Assistance to High Energy Cost Rural Communities |
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0572-0136 |
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| SUMMARY OF INFORMATION COLLECTION |
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Date Prepared |
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Jun-07 |
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| INSTRUCTIONS: |
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> |
(f) TOTAL |
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(h) TOTAL |
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(k) TOTAL |
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| Use this form when a single information collection document involves multiple reporting and |
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> |
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= (e) Average |
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= (g) Average |
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= (j) Average |
| recordkeeping requirements. |
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> |
(d) TOTAL |
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(f) TOTAL |
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(i) TOTAL |
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| IDENTIFICATION OF REPORTING AND RECORDKEEPPING REQUIREMENTS |
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ANNUAL BURDEN |
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FORM |
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REPORTS |
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RECORDS |
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NO(s) |
NO. OF |
NO. OF |
TOTAL |
HOURS |
TOTAL |
NO. OF |
ANNUAL |
TOTAL |
| SECTION OF |
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(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 |
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RESPON- |
(Col. d & e) |
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KEEPER |
HOURS |
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DENT |
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(Col. i & j) |
| (a) |
(b) |
(c) |
(d) |
(e) |
(f) |
(g) |
(h) |
(i) |
(j) |
(k) |
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ITEMS APPROVED UNDER THIS COLLECTION |
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Application Package |
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Narrative Grant Proposal |
Non-Form |
55 |
1 |
55 |
15.00 |
825.00 |
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RUS Environmental Profile |
Non-Form |
55 |
1 |
55 |
1.00 |
55.00 |
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Grant Award and Post Award |
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Letter of Intent |
RD 1942-46 |
12 |
1 |
12 |
1 |
12.00 |
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Grant Agreement |
Non-Form |
12 |
1 |
12 |
1 |
12.00 |
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Performance Reports |
Non-Form |
33 |
4 |
132 |
2 |
264.00 |
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Final Performance Report |
Non-Form |
12 |
1 |
12 |
5 |
60.00 |
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Recordkeeping Requirements |
Non-Form |
33 |
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| Total this Collection |
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55 |
5.05 |
278 |
4.42 |
1,228 |
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FORMS APPROVED UNDER OTHER COLLECTIONS |
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Application for Federal Assistance |
SF-424 |
55 |
1 |
55 |
0.75 |
41.25 |
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Budget Information Non-Construction Programs |
SF-424A |
55 |
1 |
55 |
3.00 |
165.00 |
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or |
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Budget Information Construction Programs |
SF-424C |
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Assurances – Non-Construction Programs |
SF-424B |
55 |
1 |
55 |
0.25 |
13.75 |
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or |
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Assurances – Construction Programs |
SF-424D |
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Disclosure of Lobbying Activities |
SF-LLL |
55 |
1 |
55 |
0.17 |
9.17 |
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Post Award |
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Financial Status Report (Long Form) or |
SF-269 |
33 |
4 |
132 |
0.50 |
66.00 |
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Financial Status Report (Short Form) |
SF-269A |
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1.50 |
0.00 |
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Request for Reimbursement or Advance of Funds or |
SF-270 |
33 |
4 |
132 |
1 |
132.00 |
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Outlay Report and Request for Reimbursement (Construction) |
SF-271 |
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1 |
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Federal Cash Transactions Report (as applicable) |
SF-272 |
0 |
0 |
0 |
2 |
0.00 |
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| RUS Form 36 (07-91) |
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