Information Collection

7 CFR 1944-N (State, Local and Tribal )

IC 188414 under ICR 201509-0575-001 · OMB 0575-0115.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0575-0115 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form AD-1049 7 CFR 1944-N (State, Local and Tribal )	Form
AD-1049 Certification Regarding Drug-Free Workplace Requirements AD-1049.pdf	Form
RD 1940-20 Request for Environmental Information RD1940-20.pdf	Form
RD 400-1 Equal Opportunity Agreement RD0400-0001.pdf	Form
RD 400-4 Assurance Agreement RD0400-0004.pdf	Form

IC Title:

7 CFR 1944-N (State, Local and Tribal )

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 7 CFR 1944.651(d) - 683

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	AD-1049	Certification Regarding Drug-Free Workplace Requirements (Grants) Alternative 1 - For Grantees Other Than Individuals	AD-1049.pdf	Yes	No	Fillable Printable
Form	RD 1940-20	Request for Environmental Information	RD1940-20.pdf	Yes	No	Fillable Printable
Form	RD 400-1	Equal Opportunity Agreement	RD0400-0001.pdf	Yes	No	Fillable Printable
Form	RD 400-4	Assurance Agreement	RD0400-0004.pdf	Yes	No	Fillable Printable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 412

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	2,748	-4,916	7,664
Annual IC Time Burden (Hours)	2,496	-4,456	6,952
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.