Summary of Burden Spreadsheet

Copy of 0572-0136 Form_36 Rev 2-26-14.xlsm

High Energy Costs Grants Rural Communities

Summary of Burden Spreadsheet

OMB: 0572-0136

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USDA - RUS
Assistance to High Energy Cost Rural Communities OMB No.




0572-0136
SUMMARY OF INFORMATION COLLECTION
Date Prepared



02/19/14

INSTRUCTIONS:
>

(h) TOTAL
(k) TOTAL

Use this form when a single information collection document involves multiple reporting and

> - = (e) Average - = (g) Average - = (j) Average
recordkeeping requirements.

>

(f) TOTAL
(i) TOTAL

IDENTIFICATION OF REPORTING AND RECORDKEEPING REQUIREMENTS




ANNUAL BURDEN





FORM

REPORTS


RECORDS


NO(s) NO. OF NO. OF TOTAL HOURS TOTAL NO. OF ANNUAL TOTAL
SECTION OF
(If "none" RESPON- RESPONSES ANNUAL PER HOURS RECORD- HOURS PER RECORD-
REGULATIONS DESCRIPTION so state) DENTS PER RESPONSES RESPONSE (Col. f & g) KEEPERS RECORD- KEEPING




RESPOND- (Col. d & e)


KEEPER HOURS




DENT




(Col. i & j)
(a) (b) (c) (d) e (f) (g) (h) (i) (j) (k)

ITEMS APPROVED UNDER THIS COLLECTION









Narrative Grant Proposal Application Non-Form 60 1.00 60 10 600.00



RUS Environmental Profile Non-Form 60 1.00 60 1 60.00


Grant Award and Post Award (Selected from 60 applicant respondents)









Grant Agreement Non-Form 12 1.00 12 1 12.00


Performance Reports Non-Form 40 4.00 160 2 320.00


Final Performance Report Non-Form 12 1.00 12 5.0 60.00
Recordkeeping Requirements Non-Form




40 3 120

Subtotal this Collection
100
304
1,052 40
120

TOTALS


344
1,172











FORMS APPROVED UNDER OTHER COLLECTIONS








Application for Federal Assistance SF-424 60 1.00 60 0.75 45.00



Budget Information Non-Construction Programs or SF-424A 60 1.00 60 1 60.00



Budget Information Construction Programs SF-424C





Assurances Non-Construction Programs or SF-424B 60 1.00 60 0.25 15.00



Assurances Construction Programs SF-424D








Assurance Re: Felony Conviction (0505-0025) AD-3031 60 1.00 60 0.05 3.00











Page __1__ of __2__

Letter of Intent (0575-0015) RD 1942-46 12 1.00 12 1.00 12.00



Certification Regarding Debarment, Suspension, etc.
60 1.00 60 0.05 3.00



Disclosure of Lobbying Activities SF-LLL 60 1.00 60 0.17 10.20



Post Award









Federal Financial Report SF-425 40 4.00 160 1.50 240.00



Request for Reimbursement or Advance of Funds of SF-270 40 4.00 160 1.00 160.00



Outlay Report and Request for Reimbursement (Const.) SF-271


1











RUS Form 36 (07-91)







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