Information Collection

Federal State Marketing Improvement Prog. (State, Local, Tribal Gov't.)

IC 45630 under ICR 201004-0581-006 · OMB 0581-0240.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0581-0240 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form AD-1047 Cert. regarding Debarment, Suspension, & Other-Primary Transactions Federal State Marketing Improvement Prog. (State, Local, Tribal Gov't.)	Form and Instruction
Form AD-1048 Cert. regarding Debarment, Suspension, Ineligibility & Voluntary Exclusion--Lower Tier Transactions Federal State Marketing Improvement Prog. (State, Local, Tribal Gov't.)	Form and Instruction
Form AD-1049 Cert. regarding Drug Free Workplace Requirements Federal State Marketing Improvement Prog. (State, Local, Tribal Gov't.)	Form and Instruction
AD-1047 Cert. regarding Debarment, Suspension, & Other-Primary T ad1047.pdf	Form and Instruction
AD-1048 Cert. regarding Debarment, Suspension, Ineligibility & V ad1048.pdf	Form and Instruction
AD-1049 Cert. regarding Drug Free Workplace Requirements ad1049.pdf	Form and Instruction

IC Title:

Federal State Marketing Improvement Prog. (State, Local, Tribal Gov't.)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 7 CFR 3015

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	AD-1047	Yes	No	Fillable Printable
Form and Instruction	AD-1048	Yes	No	Fillable Printable
Form and Instruction	AD-1049	Yes	No	Fillable Printable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 75

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 60 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	425	345	80
Annual IC Time Burden (Hours)	7,115	4,475	2,640
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.

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