Summary Burden Spreadsheet -Form 36

USDA - RUS		Title of Information Document						OMB No.
		Rural Alaska Village Grant Program (RAVG) - (Associated with a final rule)						0572-NEW
SUMMARY OF INFORMATION COLLECTION								Date Prepared
								Aug. 2015
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-
NOFA	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)
	Burden Approved under this Package
1784.17
1784.18(a)	Application for Federal Assistance	SF 424	25	1	25	1.00	25
1784.19(a)(1)		(4040-0004)
1784.19(a)(2)	Preliminary Engineering Report	Written	25	1	25	4.00	100
1784.21(b)(3)	Certification Regarding Debarment, Suspension, and Other Responsibility Matters - Primary Covered Transactions	AD-1047	25	1	25	0.25	6
1784.21(b)(4)	Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Transaction.”	AD-1048	25	1	25	0.25	6
1784.21(b)(5)	Certification Regarding Drug-Free Workplace	AD-1049	25	1	25	0.25	6
1784.21(b)(8)	Certification for Contracts, Grants and Loans Regarding Lobbying	RD Instr. 1940-Q, Exhibit A-1	25	1	25	0.25	6
1784.21(b)(1)	Equal Opportunity Agreement	RD 400-1	25	1	25	0.08	2
		(0575-0018)
1784.21(b)(9)	Certification Regarding Prohibited Tying Arrangements	Written	25	1	25	0.25	6
1784.19(a)(5)	Business Plan	Written	15	1	15	4.00	60
1784.19	Land Surveyors Certification and Opinion of Right of Way	Written	15	1	15	1.00	15
1784.27(a)	Grant Agreement - (The two grant agreements specific to RAVG program participants and the associated burden are included)..	RUS Bulletin 1780-12; RAVG (0572-0121)	15	1	15	1.00	15
1784.28	Audits	Written	15	1	15	8.00	120
1784.21(b)(2)	Assurance Agreement	RD 400-4	25	1	25	0.25	6
		(0575-0018)
1784.(36)(b)	Approved Contract Documents	Written	15	1	15	4.00	60
1784.21(e)	Letter of Intent to Meet Conditions	RD 1942-46	15	1	15	1.00	15
		(0575-0015)
1784.19	Opinion of Counsel Relative to Right-of-Way & Easements	RD 442-22	15	1	15	1.00	15
		(0575-0015)
1784.21(b)(6)	Civil Rights Compliance Assurance	Written	15	1	15	0.25	4
	Burden hours associated with THIS package				345		469			Page 1
	FORMS APPROVED UNDER OTHER OMB NUMBERS
1784.18(a)	Budget Information - Non-construction Programs	SF 424A	25	1	25	1.00	25
		(0348-0044)
1784.18(a)	Assurances - Non-construction Programs	SF 424B (0348-0040)	15	1	15	0.25	4
1784.19(a)(1)	Budget Information - Construction Programs	SF 424C	25	1	25	1.00	25
		(4040-0008)
1784.19(a)(1)	Assurances - Construction Programs	SF 424D	15	1	15	0.25	4
		(4040-0009)
1784.21(b)(7)	Disclosure of Lobbying Acitivities	SF LLL	15	1	15	0.25	4
1784.21(b)(6)	Compliance Assurance	RUS Form 266 (0572-0032)	15	1	15	0.50	8
	Total burden associated with OTHER packages				110		69			Page 2
	Total burden hours associated with THIS package				345		469			Page 1
	COMBINED burden associated with this package				455		538