| USDA - RUS | 
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		| SUMMARY  OF  INFORMATION  COLLECTION | 
 | 7 CFR 1775 Technical Assistance Programs | 
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 | Date  Prepared | 
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 | ARRA Funding - 2009 | 
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 | Apr-10 | 
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		| INSTRUCTIONS: |  | 
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 | > | (f)  TOTAL | 
 | (h)  TOTAL | 
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		| Use this form when a single information collection document involves multiple reporting and | 
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 | > | - | = (e)  Average | - | = (g)  Average | - | = (j)  Average | 
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		| recordkeeping requirements. | 
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 | > | (d)  TOTAL | 
 | (f)  TOTAL | 
 | (i)  TOTAL | 
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		| IDENTIFICATION  OF  REPORTING  AND  RECORDKEEPPING  REQUIREMENTS | 
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 | ANNUAL  BURDEN | 
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 | FORM | 
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 | REPORTS | 
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 | RECORDS | 
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 | NO(s) | NO.  OF | NO.  OF | TOTAL | HOURS | TOTAL | NO.  OF | ANNUAL | TOTAL | 
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		| SECTION  OF | 
 | (If  "none" | RESPON- | RESPONSES | ANNUAL | PER | HOURS | RECORD- | HOURS  PER | RECORD- | 
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		| REGULATIONS | DESCRIPTION | so  state) | DENTS | PER | RESPONSES | RESPONSE | (Col.  f  &  g) | KEEPERS | RECORD- | KEEPING | 
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 | RESPON- | (Col.  d  &  e) | 
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 | KEEPER | HOURS | 
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 | DENT | 
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 | (Col.  i  &  j) | 
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		| (a) | (b) | (c) | (d) | (e) | (f) | (g) | (h) | (i) | (j) | (k) | 
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 | Items Cleared With This Package | 
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		| 1775.10(d)(3) | Narrative | Written | 15 | 1 | 15 | 2.00 | 30 | 1 | 1 | 1 | 
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		| 1775.10(d)(6) | Budget justification | Written | 15 | 1 | 15 | 10.00 | 150 | 
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		| 1775.10(d)(1) | Legal Authority and Responsibility | Written | 15 | 1 | 15 | 0.25 | 4 | 
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		| 1775.10(d)(2) | Evidence of Tax Exempt Status | Written | 15 | 1 | 15 | 0.25 | 4 | 
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		| 1775.10(d)(8) | Scope of Work | Written | 15 | 1 | 15 | 12.00 | 180 | 
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		| 1775.13 | Grant Agreement | RUS Bulletin 1775-1 | 1 | 1 | 1 | 2.00 | 2 | 
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		| 1775.2 | Project Performance Report | Written | 1 | 4 | 4 | 12.00 | 48 | 
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		| 1775.21 | Audit | Written | 1 | 1 | 1 | 3.00 | 3 | 
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 | Financial Statements | Written | 1 | 1 | 1 | 1.00 | 1 | 
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		| 1775.10 | Statement concerning assistance under the National Forest Service-Dependent Rural Communities Economic Diversification Act | Written | 1 | 1 | 1 | 1.00 | 1 | 
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		| 1775.10(c)(3) | Certification Regarding Debarment, Suspension, and Other Responsibility Matters - Primary Covered Transactions | AD-1047 | 1 | 1 | 1 | 0.25 | 0 | 
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		| 1775.10(c)(5) | Certification Regarding Debarment | AD-1048 | 1 | 1 | 1 | 0.25 | 0 | 
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		| 1775.10(c)(6) | Documentation of assistance provided to Rural Development employees | Written | 1 | 1 | 1 | 0.25 | 0 | 
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		| 1775.10(c)(9) | Indirect Cost Agreement | Written | 15 | 1 | 15 | 1.00 | 15 | 
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		| 1775.10(c)(10) | Statement of Compliance , Title VI of Civil Rights Act of 1964 | Written | 1 | 1 | 1 | 0.50 | 1 | 
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		| 1775.10(d)(4) | Latest Financial Information | Written | 15 | 1 | 15 | 1.00 | 15 | 
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		| 1775.10(d)(7) | Evidence of Financial Management System | Written | 15 | 1 | 15 | 0.25 | 4 | 
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		| 1775.10(c)(4) | Certification Regarding Drug-Free Workplace Requirements (Grants) Alternative I - for Grantees Other Than Individuals | AD-1049 | 1 | 1 | 1 | 0.25 | 0 | 
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 | Request for Advance or Reimbursement | SF 270 | 1 | 12 | 12 | 1.00 | 12 | 
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 | (0348-0004) | 
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 | SubTotal Burden Hours | 
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 | 471 | 1 | 1 | 1 | 
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 | TOTAL BURDEN HOURS UNDER THIS COLLECTION PACKAGE | 
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 | 145 | 
 | 472 | 
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		| 1775.10(c)(1) | Application for Federal Assistance (Non-construction Programs) | SF-424 | 15 | 1 | 15 | 0.75 | 11 |  |  |  | 
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 | 4040-0004 | 
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		| 1775.10(c)(2) | Budget Information--Non-Construction Programs | SF-424A | 15 | 1 | 15 | 3.00 | 45 |  |  |  | 
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 | 4040-0006 | 
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		| 1775.10(c)(2) | Assurances--Non-construction Programs | SF-424B | 15 | 1 | 15 | 0.25 | 4 | 
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		| 1775.10(c)(8) | Equal Opportunity Agreement | RD 400-1 | 1 | 1 | 1 | 0.17 | 0 | 
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		| 1775.10(c)(7) | Assurance Agreement | RD 400-4 | 1 | 1 | 1 | 0.25 | 0 | 
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 | (0575-0018) | 
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 | Federal Financial Report | SF 425 | 1 | 4 | 4 | 1.50 | 6 | 
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		| 1775.10(c)(11) | Disclosure of Lobbying Activities | SF LLL | 1 | 1 | 1 | 0.25 | 0 | 
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 | (0348-0046) | 
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		| RUS  Form  36   (07-91) | 
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 | Page __2__  of __2__ | 
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