Information Collection

Risk Management Education Partnerships - Targeted States

IC 219554 under ICR 201508-0563-002 · OMB 0563-0067.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form AD-1047 Risk Management Education Partnerships - Targeted States	Form and Instruction
AD-1047 Certification Regarding Debarment, Suspension & other Re AD-1047 (Dec '15).pdf	Form and Instruction
AD-1049 Certification Regarding Drug-Free Work Place Requirement AD-1049 (Dec '15).pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 7 CFR 400

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	AD-1047	Certification Regarding Debarment, Suspension & other Responsibility Matters	AD-1047 (Dec '15).pdf		Yes	No	Printable Only
Form and Instruction	AD-1049	Certification Regarding Drug-Free Work Place Requirements (Grants)	AD-1049 (Dec '15).pdf		Yes	No	Printable Only

Line of Business: Natural Resources

Subfunction: Agricultural Innovation and Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 30

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	120	120
Annual IC Time Burden (Hours)	518	518
Annual IC Cost Burden (Dollars)	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.