Summary Burden Spreadsheet -Form 36

FINAL RAVG Grid -2015 -updated (rev.) 9-1-15.xls

The Rural Alaska Village Grant (RAVG) Program

Summary Burden Spreadsheet -Form 36

OMB: 0572-0150

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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
























































































































































































































































































































































































































































































File Typeapplication/vnd.ms-excel
AuthorDawn Wolfgang
Last Modified ByDaskal, MaryPat - RD, Washington, DC
File Modified2015-09-01
File Created1999-05-21

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