Information Collection

Repowering Assistance Program - Individuals

IC 192374 under ICR 201404-0570-002 · OMB 0570-0066.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0570-0066 can be found here:

2017-10-11 - Revision of a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form RD 4288-4 Repowering Assistance Program Application Repowering Assistance Program - Individuals	Form
Form RD 4288-5 Repowering Assistance Program Agreement Repowering Assistance Program - Individuals	Form
Form RD 4288-6 Repowering Assistance Program Payment Request Repowering Assistance Program - Individuals	Form
Form RD 400-1 Equal Opportunity Agreement Repowering Assistance Program - Individuals	Form
Form RD 400-4 Assurance Agreement Repowering Assistance Program - Individuals	Form
Form RD 1940-20 Request for Environmental Information Repowering Assistance Program - Individuals	Form
Form AD-1047 Certification Regarding Debarment, Suspension, & other Responsibility Matters - Primary Covrd Trans Repowering Assistance Program - Individuals	Form
Form AD-1048 Certification Regarding Debarment, Suspension, & other Responsibility Matters, Lower Tier Covrd Trans Repowering Assistance Program - Individuals	Form
RD 1940-Q Exhb A-1.pdf	Other-Certification
RD 4288-4 Repowering Assistance Program Application RD4288-0004.pdf	Form
RD 4288-5 Repowering Assistance Program Agreement RD4288-0005.pdf	Form
RD 4288-6 Repowering Assistance Program Payment Request RD4288-0006.pdf	Form
RD 400-1 Equal Opportunity Agreement RD_400-1.pdf	Form
RD 400-4 Assurance Agreement RD0400-0004_130800V05.pdf	Form
RD 1940-20 Request for Environmental Information RD 1940-20 Request for Environmental Info.pdf	Form
AD-1047 Certification Regarding Debarment, Suspension, & other R AD1047-F-0066.docx	Form
AD-1048 Certification Regarding Debarment, Suspension, & other R AD-1048.pdf	Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Repowering Assistance Program - 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:

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	RD 4288-4	Repowering Assistance Program Application	RD4288-0004.pdf	Yes	No	Fillable Printable
Form	RD 4288-5	Repowering Assistance Program Agreement	RD4288-0005.pdf	Yes	No	Fillable Printable
Form	RD 4288-6	Repowering Assistance Program Payment Request	RD4288-0006.pdf	Yes	No	Fillable Printable
Form	RD 400-1	Equal Opportunity Agreement	RD_400-1.pdf	Yes	Yes	Fillable Fileable
Form	RD 400-4	Assurance Agreement	RD0400-0004_130800V05.pdf	Yes	Yes	Fillable Fileable
Form	RD 1940-20	Request for Environmental Information	RD 1940-20 Request for Environmental Info.pdf	Yes	No	Fillable Printable
Form	AD-1047	Certification Regarding Debarment, Suspension, & other Responsibility Matters - Primary Covrd Trans	AD1047-F-0066.docx	Yes	No	Fillable Printable
Form	AD-1048	Certification Regarding Debarment, Suspension, & other Responsibility Matters, Lower Tier Covrd Trans	AD-1048.pdf	Yes	No	Fillable Printable
Other-Certification			RD 1940-Q Exhb A-1.pdf	No		Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	14	-116	130
Annual IC Time Burden (Hours)	121	-2,491	2,612
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.