Felony or Tax Delinquent Corporations

Representations Regarding Felony Conviction and Tax Delinquent Status for Corporate Applicants & Awardees

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0505-0025 can be found here:

Documents and Forms

Document Name Document Type
Form AD-3030 Felony or Tax Delinquent Corporations Form
AD-3030 Assurance Regarding Felony Conviction or Tax Delinquent AD-3030 02-25-16 Rev Reprsntn Reg Felony and Tax Delinquent.docx Form
AD-3031 Representation Regarding Felony Convition and Tax Delinq AD-3031 02-25-16 Rev - Assurance for Felony and Tax.docx Form
AD-3030-Y Representations Regarding Felony Conviction and Tax Deli AD-3030-Y Rev Reprsntn Reg Felony and Tax Delinquent.docx Form
AD-3031-Y Assurance Regarding Felony Conviction or Tax Delinquent AD-3031-Y Rev - Assurance for Felony and Tax.docx Form
Ad-3030-FS Representations Regarding Felony Conviction and Tax Deli AD-3030-FS - FY 12-13-14 rev Reprsntn Reg Felony and Tax Delinquent.docx Form
AD-3031-FS Assurance Regarding Felony Conviction or Tax Delinquent AD-3031 FS FY 12-13-14 rev Assurance for Felony and Tax.docx Form

Information Collection (IC) Details

IC Title:	Felony or Tax Delinquent Corporations	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	AD-3030	Assurance Regarding Felony Conviction or Tax Delinquent Status for Corporate Applicants	AD-3030 02-25-16 Rev Reprsntn Reg Felony and Tax Delinquent.docx	Yes	No	Printable Only
Form	AD-3031	Representation Regarding Felony Convition and Tax Delinquent Status for Corporate Applicants	AD-3031 02-25-16 Rev - Assurance for Felony and Tax.docx	Yes	No	Printable Only
Form	AD-3030-Y	Representations Regarding Felony Conviction and Tax Delinquent Status for Corporate Applicants FY '12, '13, '14	AD-3030-Y Rev Reprsntn Reg Felony and Tax Delinquent.docx	Yes	No	Printable Only
Form	AD-3031-Y	Assurance Regarding Felony Conviction or Tax Delinquent Status for Corporate Applicants FY'12, '13, '14	AD-3031-Y Rev - Assurance for Felony and Tax.docx	Yes	No	Printable Only
Form	Ad-3030-FS	Representations Regarding Felony Conviction and Tax Delinquent Status for Corporate Applicants FY'12, '13, '14	AD-3030-FS - FY 12-13-14 rev Reprsntn Reg Felony and Tax Delinquent.docx	Yes	No	Printable Only
Form	AD-3031-FS	Assurance Regarding Felony Conviction or Tax Delinquent Status for Corporate Applicants FY'12, '13, '14	AD-3031 FS FY 12-13-14 rev Assurance for Felony and Tax.docx	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: 1	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1	-2,256,096	2,256,097
Annual IC Time Burden (Hours)	1	-564,023	564,024
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.