State and Local Governments

The Rural Alaska Village Grant (RAVG) Program

OMB: 0572-0150

IC ID: 209668

Documents and Forms
Document Name
Document Type
Form
Form
Form
Form
Form and Instruction
Form
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Form
Form
Form and Instruction
Form and Instruction
Form
Form
IC Document
IC Document
IC Document
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IC Document
Information Collection (IC) Details

View Information Collection (IC)

State and Local Governments 0572
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form AD-1048 Certification Regarding Debarment, Suspension and other Responsibility Matters - Lower Tier Covered Transactions. AD1048-F-01-92.docx http://www.ocio.usda.gov/policy-directives-records-forms/forms-management/approved-computer-generated-forms Yes No Fillable Printable
Form AD-1047 Certificate Regarding Debarment AD1047-F-01-92.docx http://www.ocio.usda.gov/policy-directives-records-forms/forms-management/approved-computer-generated-forms Yes No Fillable Printable
Form AD-1049 Certification Regarding Drug-Free Workplace Requirements (Grrants) Alternative I - for Grantees Other Than Individuals AD1049-F-05-90.docx http://www.ocio.usda.gov/policy-directives-records-forms/forms-management/approved-computer-generated-forms Yes No Fillable Printable
Form and Instruction RD Instruction 1940Q A-1 Certification for Contracts, Grants, and Loans RD Instruction 1940Q A-1.pdf http://www.rurdev.usda.gov/FormsAndPublications.html Yes No Fillable Printable
Form RD 400-1 Equal opportunity Agreement RD400-1.pdf http://www.rurdev.usda.gov/FormsAndPublications.html Yes No Fillable Printable
Form RD 400-4 Assurance Agreement RD400-4.pdf http://www.rurdev.usda.gov/FormsAndPublications.html Yes No Fillable Printable
Form RD 442-22 Opinion of Counsel Regarding Right of Way RD442-22.pdf http://www.rurdev.usda.gov/FormsAndPublications.html Yes No Fillable Printable
Form RD 1942-46 Letter of Intent to Meet Conditions RD1942-46.pdf http://www.rurdev.usda.gov/FormsAndPublications.html Yes No Fillable Printable
Form and Instruction SF 424 Application for Federal Assistance SF424.pdf http://apply07.grants.gov/apply/forms/sample/SF424_2_1-V2.1.pdf Yes Yes Fillable Fileable
Form and Instruction RUS Bulletin 1780-12 RUS Bulletin 1780-12 RUS_Bulletin_1780-12.pdf http://www.rurdev.usda.gov/FormsAndPublications.html Yes No Fillable Printable
Form None RAVG ANTHC Grant Agreement RAVG ANTHC Grant Agreement FINAL.doc http://www.rurdev.usda.gov/FormsAndPublications.html No   Fillable Printable
Form None RAVG SOA Grant Agreement RAVG SOA Grant Agreement FINAL.docx http://www.rurdev.usda.gov/FormsAndPublications.html No   Fillable Printable

Community and Social Services Community and Regional Development

 

15 0
   
State, Local, and Tribal Governments
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 207 0 207 0 0 0
Annual IC Time Burden (Hours) 281 0 281 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Budget Information SF424C_.pdf 12/12/2013
Assurances - Construction Programs SF424D.pdf 12/12/2013
Disclosure of Lobbying Acitivites SFLLL.pdf 12/12/2013
SF-424A, “Budget Information--Non-Construction Programs SF424A-V1.0.pdf 07/29/2015
SF-424B, “Assurances--Non-construction Programs SF424B-V1.1.pdf 07/29/2015
RUS Form 266 “Compliance Assurance RUS266.pdf 07/29/2015
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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