Information Collection

SCBGP (Farm Bill)

IC 185494 under ICR 200812-0581-001 · OMB 0581-0248.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0581-0248 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form AD-1047 SCBGP (Farm Bill)	Form and Instruction
AD-1047 Certification Regarding Debarment, Suspension, & Other R AD-1047.pdf www.grants.gov	Form and Instruction
AD-1048 Certification Regarding Debarment, Suspension, Ineligibi AD 1048.pdf www.whitehouse.gov/omb/grants/grants_forms.html	Form and Instruction
AD-1049 certification Regarding Drug-Free Workplace Requirements AD-1049.pdf www.whitehouse.gov/omb/grants/grants_forms.html	Form and Instruction

IC Title:

SCBGP (Farm Bill)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 7 CFR 3015 et seq

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 and Instruction	AD-1047	Certification Regarding Debarment, Suspension, & Other Responsibility Matters	AD-1047.pdf	http://www.grants.gov	Yes	Yes	Fillable Fileable
Form and Instruction	AD-1048	Certification Regarding Debarment, Suspension, Ineligibility & Voluntary Exclusion	AD 1048.pdf	http://www.whitehouse.gov/omb/grants/grants_forms.html	Yes	Yes	Fillable Printable
Form and Instruction	AD-1049	certification Regarding Drug-Free Workplace Requirements (grants) Alternative I	AD-1049.pdf	http://www.whitehouse.gov/omb/grants/grants_forms.html	Yes	Yes	Fillable Printable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 56

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 75 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	510	510
Annual IC Time Burden (Hours)	1,439	1,439
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.