Summary Form 36

FINAL Spreadsheet Summary -8-21-09.xls

Special Evaluation Assistance for Rural Communities and Households Program (SEARCH)

Summary Form 36

OMB: 0572-0146

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USDA - RUS
Title of Information Document




OMB No.



Special Evaluation Assistance for Rural Communities and Households Program (SEARCH) 0572-New
SUMMARY OF INFORMATION COLLECTION
Date Prepared



December-09
INSTRUCTIONS:

> (f) TOTAL
(h) TOTAL
(k) TOTAL
Use this form when a single information collection document involves multiple reporting and


> - = (e) Average - = (g) Average - = (j) Average
recordkeeping requirements.


> (d) TOTAL
(f) TOTAL
(i) TOTAL
IDENTIFICATION OF REPORTING AND RECORDKEEPPING REQUIREMENTS




ANNUAL BURDEN





FORM

REPORTS


RECORDS


NO(s) NO. OF NO. OF TOTAL HOURS TOTAL NO. OF ANNUAL TOTAL
SECTION OF
(If "none" RESPON- RESPONSES ANNUAL PER HOURS RECORD- HOURS PER RECORD-
NOFA DESCRIPTION so state) DENTS PER RESPONSES RESPONSE (Col. f & g) KEEPERS RECORD- KEEPING




RESPON- (Col. d & e)


KEEPER HOURS




DENT




(Col. i & j)
(a) (b) (c) (d) (e) (f) (g) (h) (i) (j) (k)












Burden associated with this package









NON-FORM BURDEN









Project Narrative Written 50 1 50 2.00 100














Supporting documentation Written 50 1 50 6.00 300














Certification Regarding Debarment AD-1047 40 1 40 0.25 10














Certification Regarding Drug-Free Workplace AD-1049 40 1 40 0.25 10














Certification for Contracts, Grants and Loans Regarding Lobbying Written 40 1 40 0.25 10














Certification Regarding Prohibited Tying Arrangements Written 40 1 40 0.25 10














Agreements for professional services Written 40 1 40 4.00 160














Relationship or Assocation with RUS Employees Written 40 1 40 0.25 10














Contracts for other services Written 40 1 40 2.00 80














Grant Agreement Written 40 1 40 1.00 40














Audits Written 10 1 10 8.00 80














Management report Written 30 1 30 8.00 240

























Burden hours associated with this package
50
820
1,050

Page 1























FORMS APPROVED UNDER OTHER OMB NUMBERS









Equal Opportunity Agreement RD 400-1 40 1 40 0.17 7




(0575-0018)






























Assurance Agreement RD 400-4 40 1 40 0.25 10




(0575-0018)






























Application for Federal Assistance SF 424 50 1 50 1.00 50




(4040-0004)



















Budget Information - Non-Construction Programs SF 424A 50 1 50 1.00 50




(4040-0006)



















Assurances - Non-Construction Programs SF 424B 50 1 50 1.00 50




(4040-0007)



















Operating Budget RD 442-7 50 1 50 5.00 250




(0575-0015)



















Agreement for Engineering Services 1942-19 40 1 40 4.00 160




(0575-0015)






























Resolution of Members or Stockholders RD 1942-8 40 1 40 1.00 40




(0575-0015)








Total burden associated with other packages


360
617

Page 2






































































































































































































































































File Typeapplication/vnd.ms-excel
AuthorDawn Wolfgang
Last Modified ByMarypat.daskal
File Modified2009-12-14
File Created1999-05-21

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