Information Collection

Technical Assistance Training Grant Program

IC 190171 under ICR 201003-0572-002 · OMB 0572-0144.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form AD 1047 Technical Assistance Training Grant Program	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 http:www.usda.gov/rus/water/wwforms.htm	Form
SF LLL Disclosure for LobbyingActivities sflllin.pdf http:www.usda.gov/rus/water/wwforms.htm	Form
AD-1048 Debarment of Lower Tier Transactions usda1048.pdf www.usda.gov/rus/water/wwforms.htm	Form and Instruction
Grant Agreement Grant Agreement.doc	Form
SF 270 Request for Advance or Reimbursement sf270.pdf www.forms.gov	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	AD-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 and Instruction	SF 270	Request for Advance or Reimbursement	sf270.pdf	http://www.forms.gov	No		Fillable Printable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 15

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

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

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	145	-212	357
Annual IC Time Burden (Hours)	472	-570	1,042
Annual IC Cost Burden (Dollars)	0	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.