WIC Special Project Grants

Uniform Grant Application for Non-Entitlement Discretionary Grants

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0512 can be found here:

Documents and Forms

Document Name Document Type
WIC SPG FullMini Grant FY 2014 RFA_Final.7.1.14.doc www.grants.gov Other-Request for Application
2014 WIC SPG Concept Paper RFA - Final.7.1.14.doc www.grants.gov Other-Request for Application
Request to OMB to Use 0584-0512 (WIC Special Project Grants).docx Generic Clearance Memo IC Document
FY2014 WIC Special Project Grant Supporting Statement7-2-14 rev 2.docx Supporting Statement IC Document
Terms and Conditions - FINAL.docx Terms and Conditions IC Document
SF-425 screenshot July 2013.docx SF-425 screenshot July 2013 IC Document
SF-LLL Lobbying Form.pdf SF-LLL Lobbying Form IC Document
SF424_2_1-V2.1.pdf SF 424 Application for Federal Assistance IC Document
SF424A-V1.0.pdf SF 424A Budget Information Non Construction Programs IC Document
SF424B-V1.1.pdf SF 424B Assurances Non Construction Programs IC Document
AD1049-F-05-90.pdf AD 1049 CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS (GRANTS) ALTERNATIVE I - FOR GRANTEES OTHER THAN INDIVIDUALS IC Document
AD1050-F-01-92.pdf AD 1050 CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS (GRANTS) ALTERNATIVE II - FOR GRANTEES WHO ARE INDIVIDUALS IC Document

Information Collection (IC) Details

IC Title:	WIC Special Project Grants	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Request for Application			WIC SPG FullMini Grant FY 2014 RFA_Final.7.1.14.doc	www.grants.gov	Yes	Yes	Fillable Fileable Signable
Other-Request for Application			2014 WIC SPG Concept Paper RFA - Final.7.1.14.doc	www.grants.gov	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 15	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	159	159
Annual IC Time Burden (Hours)	1,064	1,064
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Generic Clearance Memo	Request to OMB to Use 0584-0512 (WIC Special Project Grants).docx	07/02/2014
Supporting Statement	FY2014 WIC Special Project Grant Supporting Statement7-2-14 rev 2.docx	07/07/2014
Terms and Conditions	Terms and Conditions - FINAL.docx	07/02/2014
SF-425 screenshot July 2013	SF-425 screenshot July 2013.docx	07/02/2014
SF-LLL Lobbying Form	SF-LLL Lobbying Form.pdf	07/02/2014
SF 424 Application for Federal Assistance	SF424_2_1-V2.1.pdf	07/02/2014
SF 424A Budget Information Non Construction Programs	SF424A-V1.0.pdf	07/02/2014
SF 424B Assurances Non Construction Programs	SF424B-V1.1.pdf	07/02/2014
AD 1049 CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS (GRANTS) ALTERNATIVE I - FOR GRANTEES OTHER THAN INDIVIDUALS	AD1049-F-05-90.pdf	07/02/2014
AD 1050 CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS (GRANTS) ALTERNATIVE II - FOR GRANTEES WHO ARE INDIVIDUALS	AD1050-F-01-92.pdf	07/02/2014

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.