Water and Waste Loan and Grant Program - State, Local, Tribal Government

7 CFR 1780, Water and Waste Loan and Grant Program

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0572-0121 can be found here:

Documents and Forms

Document Name Document Type
Form AD 1047 Water and Waste Loan and Grant Program - State, Local, Tribal Government Form
AD 1047 Certification Regarding Debarment, Suspension, and Other ad1047.pdf www.rurdev.usda.gov/ca/pdf%20files%20and%20documents/cf%20ad%20form%201047.pdf Form
AD 1049 Drug Free Work Place ad-1049.pdf www.rurdev.usda.gov/rbs/coops/ad1049.pdf Form
Bulletin 1780-12 Grant Agreement Bulletin 1780-12..pdf www.rurdev.usda.gov/SupportDocuments/UWP-rb-12.pdf Form and Instruction
Bulleting 1780-28 Loan Resolution, Security Agreement bulletin 1780-28.doc www.googlesyndicatedsearch.com/u/RD?q=Bulleitin%201780-28 Form and Instruction
Bulletin 1780-27 Loan Resolution (Public Bodies) bulletin 1780-27.doc www.rurdev.usda.gov/RDU_Bulletins_Water_and_Environmental.html Form and Instruction

Information Collection (IC) Details

IC Title:	Water and Waste Loan and Grant Program - State, Local, Tribal Government	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 1780

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Electronic Capability
Form	AD 1047	Certification Regarding Debarment, Suspension, and Other	ad1047.pdf	http://www.rurdev.usda.gov/ca/pdf%20files%20and%20documents/cf%20ad%20form%201047.pdf	No	Fillable Printable
Form	AD 1049	Drug Free Work Place	ad-1049.pdf	http://www.rurdev.usda.gov/rbs/coops/ad1049.pdf	No	Fillable Printable
Form and Instruction	Bulletin 1780-12	Grant Agreement	Bulletin 1780-12..pdf	http://www.rurdev.usda.gov/SupportDocuments/UWP-rb-12.pdf	No	Fillable Printable
Form and Instruction	Bulleting 1780-28	Loan Resolution, Security Agreement	bulletin 1780-28.doc	http://www.googlesyndicatedsearch.com/u/RD?q=Bulleitin%201780-28	No	Fillable Printable
Form and Instruction	Bulletin 1780-27	Loan Resolution (Public Bodies)	bulletin 1780-27.doc	http://www.rurdev.usda.gov/RDU_Bulletins_Water_and_Environmental.html	No	Fillable Printable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 733	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	43,583	-3,021	46,604
Annual IC Time Burden (Hours)	91,006	-51,760	142,766
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.