Information Collection

Value-Added Producer Grants - Individuals

IC 194177 under ICR 201403-0570-001 · OMB 0570-0064.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0570-0064 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form AD 1047 Value-Added Producer Grants - Individuals	Form
AD 1047 Certification Regarding Debarment, Suspension and Other AD1047-F-01-92-0064.docx	Form
AD 1048 Certification Regarding Debarment, Suspension, Ineligibi AD1048-F-01-92-0064.docx	Form
AD 1049 Certificaqtion Regarding Drug-Free Workplace Requirement AD1049-F-05-90-0064.docx	Form
SF-424 Application for federal Assistance SF424_2_1-V2.1.pdf	Form

IC Title:

Value-Added Producer Grants - Individuals

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 4284

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	AD 1047	Certification Regarding Debarment, Suspension and Other Responsibility Matters - Primary Covered Transaction	AD1047-F-01-92-0064.docx	Yes	No	Fillable Printable
Form	AD 1048	Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions	AD1048-F-01-92-0064.docx	Yes	No	Fillable Printable
Form	AD 1049	Certificaqtion Regarding Drug-Free Workplace Requirements (Grants) Alternative I - For Grantees Other Than Individuals	AD1049-F-05-90-0064.docx	Yes	No	Fillable Printable
Form	SF-424	Application for federal Assistance	SF424_2_1-V2.1.pdf	Yes	No	Fillable Printable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 35

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 5 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	164	-205	369
Annual IC Time Burden (Hours)	3,742	-2,926	6,668
Annual IC Cost Burden (Dollars)	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.