Information Collection

Repowering Assistance Program - Individuals

IC 192374 under ICR 201003-0570-002 · OMB 0570-0066.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0570-0066 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form RD 4288-4 Repowering Assistance Program - Individuals	Form
RD 4288-4 Repowering Assistance Program Application RD 4288-4 Eligibility Application 4-5-10 version.docx	Form
RD 4288-5 Repowering Assistance Program Agreement RD 4288-5 Agreement 4-5-10 version.docx	Form
RD 4288-6 Repowering Assistance Program Payment Request RD 4288-6 Payment Request 4-5-10 version.docx	Form
RD 400-1 Equal Opportunity Agreement RD_400-1.pdf	Form
RD 400-4 Assurance Agreement RD_400-4.pdf	Form
RD 1940-20 Request for Environmental Information RD 1940-20 Request for Environmental Info.pdf	Form
AD-1047 Certification Regarding Debarment, Suspension, & other R AD-1047.pdf	Form
AD-1048 Certification Regarding Debarment, Suspension, & other R AD-1048.pdf	Form
SF-LLL Disclosure of Lobbying Activities SF-LLL.pdf	Form and Instruction

IC Title:

Repowering Assistance Program - Individuals

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

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	RD 4288-4	Repowering Assistance Program Application	RD 4288-4 Eligibility Application 4-5-10 version.docx	Yes	No	Fillable Printable
Form	RD 4288-5	Repowering Assistance Program Agreement	RD 4288-5 Agreement 4-5-10 version.docx	Yes	No	Fillable Printable
Form	RD 4288-6	Repowering Assistance Program Payment Request	RD 4288-6 Payment Request 4-5-10 version.docx	Yes	No	Fillable Printable
Form	RD 400-1	Equal Opportunity Agreement	RD_400-1.pdf	Yes	Yes	Fillable Fileable
Form	RD 400-4	Assurance Agreement	RD_400-4.pdf	Yes	Yes	Fillable Fileable
Form	RD 1940-20	Request for Environmental Information	RD 1940-20 Request for Environmental Info.pdf	Yes	No	Fillable Printable
Form	AD-1047	Certification Regarding Debarment, Suspension, & other Responsibility Matters - Primary Covrd Trans	AD-1047.pdf	Yes	No	Fillable Printable
Form	AD-1048	Certification Regarding Debarment, Suspension, & other Responsibility Matters, Lower Tier Covrd Trans	AD-1048.pdf	Yes	No	Fillable Printable
Form and Instruction	SF-LLL	Disclosure of Lobbying Activities	SF-LLL.pdf	Yes	No	Fillable Printable

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 4

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	48	48
Annual IC Time Burden (Hours)	878	878
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.