Information Collection

Rural Development Grant Programs - Private Sector

IC 186843 under ICR 200810-0570-001 · OMB 0570-0056.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form AD 1047
Rural Development Grant Programs - Private Sector
Form
RD 400-1 Equal Opportunity Agreement
RD 400-1.pdf

forms.sc.egov.usda.gov/eforms/mainservlet
Form
RD 400-4 Assurance Agreement
RD 400-4.pdf

forms.sc.egov.usda.gov/eforms/mainservlet
Form
RD 440-11 Estimate of Funds Needed
RD 440-11.pdf

forms.sc.egov.usda.gov/eforms/mainservlet
Form
RD 442-2 Statement of Budget, Income and Equity
RD 442-2.pdf

forms.sc.egov.usda.gov/eforms/mainservlet
Form and Instruction
RD 442-3 Balance Sheet
RD 442-3.pdf

forms.sc.egov.usda.gov/eforms/mainservlet
Form and Instruction
RD 422-7 Operating Budget
RD 442-7.pdf

forms.sc.egov.usda.gov/eforms/mainservlet
Form and Instruction
RD 442-22 Opinion of Counsel Relative to Rights of Way
RD 442-22.pdf

forms.sc.egov.usda.gov/eforms/mainservlet
Form
RD 442-30 Water Purchase Contract
RD 442-30.pdf

forms.sc.egov.usda.gov/eforms/mainservlet
Form
RD 1924-6 Construction Contract
RD 1924-6.pdf

forms.sc.egov.usda.gov/eforms/mainservlet
Form
RD 1924-7 Contract Change Order
RD 1924-7.pdf

forms.sc.egov.usda.gov/eforms/mainservlet
Form
RD 1924-18 Partial Payment Estimate
RD 1924-18.pdf

forms.sc.egov.usda.gov/eforms/mainservlet
Form
RD 1940-1 Request for Obligation of Funds
RD 1940-1.pdf
Form
RD 1940-20 Request for Environmental Information
RD 1940-20.pdf

forms.sc.egov.usda.gov/eforms/mainservlet
Form and Instruction
RD 1942-8 Resolution of Members or Stockholders
RD 1942-8.pdf

forms.sc.egov.usda.gov/eforms/mainservlet
Form
RD 1942-19 Agreement fo Engineering Services
RD 1942-19.pdf

forms.sc.egov.usda.gov/eforms/mainservlet
Form
RD 1942-46 Letter of Intent to Meet Conditions
RD 1942-46.pdf

forms.sc.egov.usda.gov/eforms/mainservlet
Form
RD 5002-1 Community Facilities Grant Agreement
RD 5002-1.pdf
Form
RD 5002-2A Rural Energy for America p Program Grant Agreement
5002-2A.doc
Form
RUS Bulletin 1780- Water and Waste System Grant Agreement
RUS Bulletin 1780-12.doc
Form
AD 1047 Certification Regarding Debarment, Suspension and Other
AD1047-F-01-92.pdf

www.ocio.usda.go/forms/ocio_forms.html
Form
AD 1048 Certification Regarding Debarment, Suspension, Ineligibi
AD1048-F-01-92.pdf

www.ocio.usda.go/forms/ocio_forms.html
Form
AD 1049 Certification Regarding Drug-Free Workplace Requirements
AD1049-F-05-90.pdf

www.ocio.usda.go/forms/ocio_forms.html
Form

Information Collection (IC) Details

View Information Collection (IC)

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Information Collection Instruments:
table that charts list of instruments
Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form AD 1047 Certification Regarding Debarment, Suspension and Other Responsibiility Matters AD1047-F-01-92.pdf http://www.ocio.usda.go/forms/ocio_forms.html Yes Yes Fillable Printable
Form AD 1048 Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion AD1048-F-01-92.pdf http://www.ocio.usda.go/forms/ocio_forms.html Yes Yes Fillable Printable
Form AD 1049 Certification Regarding Drug-Free Workplace Requirements (Grants) AD1049-F-05-90.pdf http://www.ocio.usda.go/forms/ocio_forms.html Yes Yes Fillable Printable
Form RD 442-22 Opinion of Counsel Relative to Rights of Way RD 442-22.pdf http://forms.sc.egov.usda.gov/eforms/mainservlet Yes Yes Fillable Printable
Form RD 442-30 Water Purchase Contract RD 442-30.pdf http://forms.sc.egov.usda.gov/eforms/mainservlet Yes Yes Fillable Printable
Form RD 1924-6 Construction Contract RD 1924-6.pdf http://forms.sc.egov.usda.gov/eforms/mainservlet Yes Yes Fillable Printable
Form RD 1924-7 Contract Change Order RD 1924-7.pdf http://forms.sc.egov.usda.gov/eforms/mainservlet Yes Yes Fillable Printable
Form RD 1924-18 Partial Payment Estimate RD 1924-18.pdf http://forms.sc.egov.usda.gov/eforms/mainservlet Yes Yes Fillable Printable
Form RD 1940-1 Request for Obligation of Funds RD 1940-1.pdf Yes No Printable Only
Form and Instruction RD 1940-20 Request for Environmental Information RD 1940-20.pdf http://forms.sc.egov.usda.gov/eforms/mainservlet Yes Yes Fillable Printable
Form RD 1942-8 Resolution of Members or Stockholders RD 1942-8.pdf http://forms.sc.egov.usda.gov/eforms/mainservlet Yes Yes Fillable Printable
Form RD 1942-19 Agreement fo Engineering Services RD 1942-19.pdf http://forms.sc.egov.usda.gov/eforms/mainservlet Yes Yes Fillable Printable
Form RD 1942-46 Letter of Intent to Meet Conditions RD 1942-46.pdf http://forms.sc.egov.usda.gov/eforms/mainservlet Yes Yes Fillable Printable
Form RD 5002-2A Rural Energy for America p Program Grant Agreement 5002-2A.doc Yes No Fillable Printable
Form RUS Bulletin 1780-12 Water and Waste System Grant Agreement RUS Bulletin 1780-12.doc Yes No Paper Only
Form RD 5002-1 Community Facilities Grant Agreement RD 5002-1.pdf Yes No Printable Only
Form RD 400-1 Equal Opportunity Agreement RD 400-1.pdf http://forms.sc.egov.usda.gov/eforms/mainservlet Yes Yes Fillable Printable
Form RD 400-4 Assurance Agreement RD 400-4.pdf http://forms.sc.egov.usda.gov/eforms/mainservlet Yes Yes Fillable Printable
Form RD 440-11 Estimate of Funds Needed RD 440-11.pdf http://forms.sc.egov.usda.gov/eforms/mainservlet Yes Yes Fillable Printable
Form and Instruction RD 442-2 Statement of Budget, Income and Equity RD 442-2.pdf http://forms.sc.egov.usda.gov/eforms/mainservlet Yes Yes Fillable Printable
Form and Instruction RD 442-3 Balance Sheet RD 442-3.pdf http://forms.sc.egov.usda.gov/eforms/mainservlet Yes Yes Fillable Printable
Form and Instruction RD 422-7 Operating Budget RD 442-7.pdf http://forms.sc.egov.usda.gov/eforms/mainservlet Yes Yes Fillable Printable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  Requested 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 11,698 0 11,698 0 0 0
Annual IC Time Burden (Hours) 56,381 0 56,381 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.