Information Collection

7 CFR 1944-N (State, Local and Tribal )

IC 188414 under ICR 200903-0575-005 · OMB 0575-0115.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0575-0115 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form AD-1049 7 CFR 1944-N (State, Local and Tribal )	Form
AD-1049 Certification Regarding Drug-Free Workplace Requirements AD1049.pdf	Form
SF-269 Financial Status Report sf269.pdf	Form
SF-270 Request For Advance Or Reimbursement sf270.pdf	Form
SF-272 Federal Cash Transactions Report sf272.pdf	Form

IC Title:

7 CFR 1944-N (State, Local and Tribal )

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 7 CFR 1944.651(d) - 683

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	AD-1049	Certification Regarding Drug-Free Workplace Requirements (Grants) Alternative 1 - For Grantees Other Than Individuals	AD1049.pdf	Yes	No	Fillable Printable
Form	SF-269	Financial Status Report	sf269.pdf	Yes	No	Fillable Printable
Form	SF-270	Request For Advance Or Reimbursement	sf270.pdf	Yes	No	Fillable Printable
Form	SF-272	Federal Cash Transactions Report	sf272.pdf	Yes	No	Fillable Printable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,092

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	7,275	7,275
Annual IC Time Burden (Hours)	6,018	6,018
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.