Energy Audit and Renewable Energy Development Assistance

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form RD 4280-2 Rural Business and Cooperative Service Grant Agreement	Form	Modified	Available
Form RD 1942-46 Letter of Intent	Form	Modified	Available
Form RD 400-4 Assurance Agreement	Form	Modified	Available
Form RD 1940-1 Request for Obligation of Funds	Form	Modified	Available
Form AD 1049 Certification Regarding Drug-Free Workplace Requirements (Grants) Alternative I	Form	Modified	Available
Form AD 1048 Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion � Lower Tier Covered Transactions	Form	Modified	Available
Form AD 1047 Certification Regarding Debarment, Suspension, and Other Responsibility Matters � Primary Covered Transactions	Form	Modified	Available
Form RD 4280-2 Rural Business and Cooperative Service Grant Agreement	Form	Modified	Available
Form RD 1942-46 Letter of Intent	Form	Modified	Available
Form RD 400-4 Assurance Agreement	Form	Modified	Available
Form RD 1940-1 Request for Obligation of Funds	Form	Modified	Available
Form AD 1049 Certification Regarding Drug-Free Workplace Requirements (Grants) Alternative I	Form	Modified	Available
Form AD 1048 Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion ? Lower Tier Covered Transactions	Form	Modified	Available
Form AD 1047 Certification Regarding Debarment, Suspension, and Other Responsibility Matters ? Primary Covered Transactions	Form	Modified	Available
JUSTIFICATION FOR CHANGE for RD Form 4280-2.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2011-06-29	Available
Spreadsheet.xls	Supplementary Document	Uploaded 2009-03-11	Available
Supporting Statement.doc	Supporting Statement A	Uploaded 2009-03-11	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
188029	Energy Audit and Energy Assistance - State and Local	Instruction	Modified
188029	Energy Audit and Energy Assistance - State and Local	Form	Modified	Rural Business and Cooperative Service Grant Agreement
188029	Energy Audit and Energy Assistance - State and Local	Form	Modified	Letter of Intent
188029	Energy Audit and Energy Assistance - State and Local	Form	Modified	Assurance Agreement
188029	Energy Audit and Energy Assistance - State and Local	Form	Modified	Request for Obligation of Funds
188029	Energy Audit and Energy Assistance - State and Local	Form	Modified	Certification Regarding Drug-Free Workplace Requirements (Grants) Alternative I
188029	Energy Audit and Energy Assistance - State and Local	Form	Modified	Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion � Lower Tier Covered Transactions
188029	Energy Audit and Energy Assistance - State and Local	Form	Modified	Certification Regarding Debarment, Suspension, and Other Responsibility Matters � Primary Covered Transactions
188026	Energy Audit and Energy Assistance - Private Sector	Instruction	Modified
188026	Energy Audit and Energy Assistance - Private Sector	Form	Modified	Rural Business and Cooperative Service Grant Agreement
188026	Energy Audit and Energy Assistance - Private Sector	Form	Modified	Letter of Intent
188026	Energy Audit and Energy Assistance - Private Sector	Form	Modified	Assurance Agreement
188026	Energy Audit and Energy Assistance - Private Sector	Form	Modified	Request for Obligation of Funds
188026	Energy Audit and Energy Assistance - Private Sector	Form	Modified	Certification Regarding Drug-Free Workplace Requirements (Grants) Alternative I
188026	Energy Audit and Energy Assistance - Private Sector	Form	Modified	Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion ? Lower Tier Covered Transactions
188026	Energy Audit and Energy Assistance - Private Sector	Form	Modified	Certification Regarding Debarment, Suspension, and Other Responsibility Matters ? Primary Covered Transactions

ICR Details

OMB Control No: 0570-0059	ICR Reference No: 201106-0570-002
Status: Historical Active	Previous ICR Reference No: 200902-0570-001
Agency/Subagency: USDA/RBS	Agency Tracking No:
Title: Energy Audit and Renewable Energy Development Assistance
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/30/2011
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/30/2011
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2012	07/31/2012	07/31/2012
Responses	865	0	865
Time Burden (Hours)	1,170	0	1,170
Cost Burden (Dollars)	0	0	0

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Abstract: The collection of information is vital to the Agency to make wise decisions regarding the eligibility of applicants and their projects in order to ensure compliance with agency provisions in order to implement this Program.

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Authorizing Statute(s): PL: Pub.L. 110 - 246 9007 Name of Law: Food, Conservation, and Energy Act of 2008
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 10533	03/11/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 10533	03/11/2009
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Energy Audit and Energy Assistance - Private Sector	AD 1049, AD 1047, RD 1940-1, RD 400-4, RD 1942-46, RD 4280-2, AD 1048	Certification Regarding Debarment, Suspension, and Other Responsibility Matters ? Primary Covered Transactions ,   Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion ? Lower Tier Covered Transactions ,   Certification Regarding Drug-Free Workplace Requirements (Grants) Alternative I ,   Request for Obligation of Funds ,   Assurance Agreement ,   Letter of Intent ,   Rural Business and Cooperative Service Grant Agreement
Energy Audit and Energy Assistance - State and Local	AD 1047, AD 1048, AD 1049, RD 1940-1, RD 1942-46, RD 400-4, RD 4280-2	Certification Regarding Debarment, Suspension, and Other Responsibility Matters � Primary Covered Transactions ,   Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion � Lower Tier Covered Transactions ,   Certification Regarding Drug-Free Workplace Requirements (Grants) Alternative I ,   Request for Obligation of Funds ,   Assurance Agreement ,   Letter of Intent ,   Rural Business and Cooperative Service Grant Agreement

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	865	865	0	0	0	0
Annual Time Burden (Hours)	1,170	1,170	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $205,283

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 06/30/2011

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