Information Collection

SEARCH - American Indian Tribes

IC 193386 under ICR 201005-0572-003 · OMB 0572-0146.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0572-0146 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form AD 1047 SEARCH - American Indian Tribes	Form and Instruction
AD 1047 Certification Regarding Debarment AD 1047.pdf www.usda.gov/rus/water/wwforms.htm	Form and Instruction
AD 1048 Certification Regarding Debarment - Lower Tiered AD 1048.pdf www.usda.gov/rus/water/wwforms.htm	Form and Instruction
Ad 1049 Certificate for a Drug Free Workplace AD 1049.pdf www.usda.gov/rus/water/wwforms.htm	Form and Instruction
SF 270 Request for Advancement or Reimbursement SF 270.pdf www.whitehouse.gov/omb/grants/sf270.pdf	Form and Instruction
SF 269A Financial Status Report - short form SF 269-A.pdf www.whitehouse.gov/omb/grants/sf269a.pdf	Form and Instruction

IC Title:

SEARCH - American Indian Tribes

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	AD 1047	Certification Regarding Debarment	AD 1047.pdf	http://www.usda.gov/rus/water/wwforms.htm	Yes	No	Fillable Printable
Form and Instruction	AD 1048	Certification Regarding Debarment - Lower Tiered	AD 1048.pdf	http://www.usda.gov/rus/water/wwforms.htm	Yes	No	Fillable Printable
Form and Instruction	Ad 1049	Certificate for a Drug Free Workplace	AD 1049.pdf	http://www.usda.gov/rus/water/wwforms.htm	Yes	No	Fillable Printable
Form and Instruction	SF 270	Request for Advancement or Reimbursement	SF 270.pdf	www.whitehouse.gov/omb/grants/sf270.pdf	Yes	No	Fillable Printable
Form and Instruction	SF 269A	Financial Status Report - short form	SF 269-A.pdf	www.whitehouse.gov/omb/grants/sf269a.pdf	Yes	No	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	32	32
Annual IC Time Burden (Hours)	68	68
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.