OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Forms and Regulatons for Grants to States for Construction and Acquisition of State Home Facilities

IC 28939 under ICR 201308-2900-029 · OMB 2900-0661.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form 10-0388-2
CERTIFICATION OF COMPLIANCE WITH PROVISIONS OF THE DAVIS-BACON ACT Forms and Regulatons for Grants to States for Construction and Acquisition of State Home Facilities		 Form and Instruction
Form 10-0388-3
SPACE PROGRAM ANALYSIS - NURSING HOME & DOMICILIARY Forms and Regulatons for Grants to States for Construction and Acquisition of State Home Facilities		 Form
Form 10-0388-4
ADULT DAY HEALTH CARE Forms and Regulatons for Grants to States for Construction and Acquisition of State Home Facilities		 Form
Form 10-0388-5
ADDITIONAL DOCUMENTS AND INFORMATION REQUIRED FOR STATE HOME CONSTRUCTION AND ACQUISITION GRANTS APPLICATION Forms and Regulatons for Grants to States for Construction and Acquisition of State Home Facilities		 Form
Form 10-0388-6
CERTIFICATION OF STATE MATCHING FUNDS TO QUALIFY FOR GROUP 1 ON THE PRIORITY LIST Forms and Regulatons for Grants to States for Construction and Acquisition of State Home Facilities		 Form
Form 10-0388-7
CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS - PRIMARY COVERED TRANSACTIONS Forms and Regulatons for Grants to States for Construction and Acquisition of State Home Facilities		 Form and Instruction
Form 10-0388-8
CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS FOR GRANTEES OTHER THAN INDIVIDUALS Forms and Regulatons for Grants to States for Construction and Acquisition of State Home Facilities		 Form and Instruction
Form 10-0388-9
CERTIFICATION REGARDING LOBBYING Forms and Regulatons for Grants to States for Construction and Acquisition of State Home Facilities		 Form and Instruction
Form 10-0388-10
CERTIFICATION OF COMPLIANCE WITH FEDERAL REQUIREMENTS Forms and Regulatons for Grants to States for Construction and Acquisition of State Home Facilities		 Form
Form 10-0388-12
CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION - LOWER TIER COVERED TRANSACTIONS Forms and Regulatons for Grants to States for Construction and Acquisition of State Home Facilities		 Form and Instruction
Form 10-0388-13
DOCUMENTS AND CERTIFICATION REQUIRED FOR STATE HOME CONSTRUCTION AND ACQUISITION GRANTS - POST-GRANT REQUIREMENTS Forms and Regulatons for Grants to States for Construction and Acquisition of State Home Facilities		 Form and Instruction
Form 10-0338-1
Documents & Information Required for State Home Construction & Acquisition Grants-Initial Application Forms and Regulatons for Grants to States for Construction and Acquisition of State Home Facilities		 Form and Instruction
2900-0661 Forms_Support_List[1].docx Instruction
10-0388-2 CERTIFICATION OF COMPLIANCE WITH PROVISIONS OF THE DAVIS
10-0388-2 7-18-13.pdf 		Form and Instruction
10-0388-3 SPACE PROGRAM ANALYSIS - NURSING HOME & DOMICILIARY
10-0388-3 7-18-13.pdf 		Form
10-0388-4 ADULT DAY HEALTH CARE
10-0388-4 7-19-13.pdf 		Form
10-0388-5 ADDITIONAL DOCUMENTS AND INFORMATION REQUIRED FOR STATE
10-0388-5 7-22-2013.pdf 		Form
10-0388-6 CERTIFICATION OF STATE MATCHING FUNDS TO QUALIFY FOR GRO
10-0388-6 7-22-13.pdf 		Form
10-0388-7 CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER
10-0388-7 7-19-2013.pdf 		Form and Instruction
10-0388-8 CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS
10-0388-8 7-19-2013.pdf 		Form and Instruction
10-0388-9 CERTIFICATION REGARDING LOBBYING
10-0388-9 7-19-13.pdf 		Form and Instruction
10-0388-10 CERTIFICATION OF COMPLIANCE WITH FEDERAL REQUIREMENTS
10-0388-10 7-19-2013.pdf 		Form
10-0388-12 CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBI
10-0388-12 7-19-2013.pdf 		Form and Instruction
10-0388-13 DOCUMENTS AND CERTIFICATION REQUIRED FOR STATE HOME CONS
10-0388-13 7-19-2013.pdf 		Form and Instruction
10-0338-1 Documents & Information Required for State Home Construc
10-0388-1 7-17-2013.pdf 		Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

layout table

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
Instruction www.va.gov/vaforms No   Printable Only
Form and Instruction 10-0388-2 www.va.gov/vaforms Yes No Fillable Printable
Form 10-0388-3 www.va.gov/vaforms Yes No Fillable Printable
Form 10-0388-4 www.va.gov/vaforms Yes No Fillable Printable
Form 10-0388-5 www.va.gov/vaforms Yes No Fillable Printable
Form 10-0388-6 www.va.gov/vaforms Yes No Fillable Printable
Form and Instruction 10-0388-7 www.va.gov/vaforms Yes No Fillable Printable
Form and Instruction 10-0388-8 www.va.gov/vaforms Yes No Fillable Printable
Form and Instruction 10-0388-9 www.va.gov/vaforms Yes No Fillable Printable
Form 10-0388-10 www.va.gov/vaforms Yes No Fillable Printable
Form and Instruction 10-0388-12 www.va.gov/vaforms Yes No Fillable Printable
Form and Instruction 10-0388-13 www.va.gov/vaforms Yes No Fillable Printable
Form and Instruction 10-0338-1 www.va.gov/vaforms Yes No Fillable Printable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 50 0 0 0 0 50
Annual IC Time Burden (Hours) 1,200 0 0 0 0 1,200
Annual IC Cost Burden (Dollars) 0 0 0 0 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.
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