Information Collection

Value-Added Producer Grants - Individuals

IC 194177 under ICR 201102-0570-002 · OMB 0570-0064.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0570-0064 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form RD 400-4 Value-Added Producer Grants - Individuals	Form
RD 400-4 Assurance Agreement RD400-4.pdf	Form
RD 1942-46 Letter of Intent RD1942-46.pdf	Form
RD 1940-20 Request for Environmental Information RD1940-20.pdf	Form
RD 4284-2 Value-Added Producer Grant Agreement RD 4284-2.doc	Form
RD 1940-1 Request for Obligation of Funds RD1940-1.pdf	Form
SF 3881 ACH Vendor/Miscellaneous Payment Enrollment Form SF 3881.pdf	Form and Instruction
AD 1047 Certification Regarding Debarment, Suspension and Other AD1047-F-01-92.pdf	Form
AD 1048 Certification Regarding Debarment, Suspension, Ineligibi AD1048-F-01-92.pdf	Form
AD 1049 Certificaqtion Regarding Drug-Free Workplace Requirement AD1049-F-05-90.pdf	Form
SF LLL Disclosure of Lobbying Activities SF LLL.pdf	Form and Instruction

IC Title:

Value-Added Producer Grants - Individuals

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 4284

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 400-4	Assurance Agreement	RD400-4.pdf	Yes	Yes	Fillable Printable
Form	RD 1942-46	Letter of Intent	RD1942-46.pdf	Yes	Yes	Fillable Printable
Form	RD 1940-20	Request for Environmental Information	RD1940-20.pdf	Yes	No	Fillable Printable
Form	RD 4284-2	Value-Added Producer Grant Agreement	RD 4284-2.doc	Yes	No	Fillable Printable
Form	RD 1940-1	Request for Obligation of Funds	RD1940-1.pdf	Yes	No	Fillable Printable
Form and Instruction	SF 3881	ACH Vendor/Miscellaneous Payment Enrollment Form	SF 3881.pdf	Yes	No	Fillable Printable
Form	AD 1047	Certification Regarding Debarment, Suspension and Other Responsibility Matters - Primary Covered Transaction	AD1047-F-01-92.pdf	Yes	No	Fillable Printable
Form	AD 1048	Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions	AD1048-F-01-92.pdf	Yes	No	Fillable Printable
Form	AD 1049	Certificaqtion Regarding Drug-Free Workplace Requirements (Grants) Alternative I - For Grantees Other Than Individuals	AD1049-F-05-90.pdf	Yes	No	Fillable Printable
Form and Instruction	SF LLL	Disclosure of Lobbying Activities	SF LLL.pdf	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: 60

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 5 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	369	369
Annual IC Time Burden (Hours)	6,668	6,668
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.