RUS Form 36, Summary of Information Collection

0572-0134-REVISED 2014 RUS Form 36 -.xls

Public Television Digital Transition Grant Program

RUS Form 36, Summary of Information Collection

OMB: 0572-0134

Document [xlsx]
Download: xlsx | pdf
USDA - RUS
Title of Information Document




OMB No.









0572-0134
SUMMARY OF INFORMATION COLLECTION
Public Television Station Digital Transition




Date Prepared



Grant Program





2014
INSTRUCTIONS:

> (f) TOTAL
(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.


> (d) TOTAL
(f) TOTAL
(i) TOTAL
IDENTIFICATION OF REPORTING AND RECORDKEEPPING 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




RESPON- (Col. d & e)


KEEPER HOURS




DENT




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

Items Cleared Under this Collection









Applicant Registration in "System for Award Management" (SAM)
30 1 30 1.00 30.00



Application Package - Based on past submissions, the estimated 23 hours per response time to complete the application package covers all required written documentation set forth in the Application Guide including the following summary worksheet and certification forms found in the Tool Kit. 30 1 30 23.00 690.00

-- Summary Worksheet


0.02


Certifications are Mandatory -- Equal Opportunity and Nondiscrimination Certification



0.02




-- Certificate Regarding Architectural Barriers



0.02




-- Certificate Regarding Flood Hazard Area Precautions



0.02




-- Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 Certification



0.02




-- Certification Regarding Drug-Free Workplace Requirements Alternative I - for Grantees other than Individuals



0.25




-- Certification Regarding Debarment, Suspension, and other Responsibility Matters -- Primary Covered Transactions



0.25












Page _ 1_ of __ 2__

-- Certification Regarding Lobbying for Contracts, Grants, Loans, and Cooperative Agreements



0.25




-- Public Television Station Digital Transition Grant Program Environmental Questionnaire/Certification



0.06




-- Federal Obligations Certification on Delinquent Debt



0.02




--Survey on Ensuring Equal Opportunity for Applicants (approved under OMB 1894-0010)



0.08




Grant Agreement
8 1 8 3.00 24.00










Items Cleared Under Other Dockets

















Application for Federal Assistance (common form approved under 4040-0004) SF-424 30 1 30 0.75 22.50



Representations Regarding Felony Conviction and Tax Delinquent Status for Corporate Applicants (approved under OMB 0505-0025) AD-3030 30 1 30 0.25 7.50































Total Hours This Collection
30
68
744.00
RUS Form 36 (07-91)







Page __2__ of __2__
File Typeapplication/vnd.ms-excel
AuthorDawn Wolfgang
Last Modified ByHunt, Rebecca - RD, Washington, DC
File Modified2014-08-19
File Created1999-05-21

© 2024 OMB.report | Privacy Policy