Information Collection

Technical Assistance Training Grant Program

IC 190171 under ICR 200907-0572-005 · OMB 0572-0144.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0572-0144 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form AD 1047 Technical Assistance Training Grant Program	Form
RD 0400-1 Equal Opportunity Agreement 0400-01.pdf www.usda.gov/rus/water/wwforms.htm	Form
RD 0400-04 Assurance Agreement 0400-04.pdf	Form
AD 1047 Certificate of Debarment, etc. for Primary Transactions ad1047.pdf www.usda.gov/rus/water/wwforms.htm	Form
AD 1049 Certificate for Drug-Free Workplace ad1049.pdf	Form
SF LLL Disclosure for LobbyingActivities sflllin.pdf	Form
usda 1048 Debarment of Lower Tier Transactions usda1048.pdf www.usda.gov/rus/water/wwforms.htm	Form and Instruction
Grant Agreement Grant Agreement.doc	Form

IC Title:

Technical Assistance Training Grant Program

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 1926

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	Certificate of Debarment, etc. for Primary Transactions	ad1047.pdf	http://www.usda.gov/rus/water/wwforms.htm	Yes	No	Printable Only
Form	AD 1049	Certificate for Drug-Free Workplace	ad1049.pdf	http:www.usda.gov/rus/water/wwforms.htm	Yes	No	Paper Only
Form	SF LLL	Disclosure for LobbyingActivities	sflllin.pdf	http:www.usda.gov/rus/water/wwforms.htm	Yes	No	Fillable Printable
Form and Instruction	usda 1048	Debarment of Lower Tier Transactions	usda1048.pdf	http://www.usda.gov/rus/water/wwforms.htm	Yes	No	Fillable Printable
Form	None	Grant Agreement	Grant Agreement.doc		No		Paper Only
Form	RD 0400-1	Equal Opportunity Agreement	0400-01.pdf	http://www.usda.gov/rus/water/wwforms.htm	Yes	No	Printable Only
Form	RD 0400-04	Assurance Agreement	0400-04.pdf	http:www.usda.gov/rus/water/wwforms.htm	Yes	No	Printable Only

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 30

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	357	357
Annual IC Time Burden (Hours)	1,042	1,042
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.