0584-0512 Burden Table

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Overview

Burden Table
Forms Burden Detail

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Sheet 1: Burden Table

			Pre-Award RFA					Pre-Award Forms		Total Pre-Award Burden	Post-Award Reporting (excludes forms)			Post Award Forms		Total Post Award Reporting	Recordkeeping		Total
Appendix	Grant	Affected Public	Estimated No. of Annual Respondents (Applicants)	Frequency per Respondent	Total Annual Responses	Estimated Time (Hours) to complete each Application	Total Estimated Pre-Award Burden Hours	Pre-Award Reporting FORMS Responses (8 per SLT; 9 per business IC)	Pre-Award Reporting FORMS burden (~6.4 / 6.7 hours per grantee)	Pre-Award Burden Hours	Estimated No of Annual Respondents (Grantees)	Post Award Reporting Responses (4 per grantee)	Post Award Reporting burden (14 hours per grantee)	Post Award FORMS Responses (5 per grantee)	Post Award Reporting burden (14 hours per grantee)	Post Award Hours	Record-keeping Responses (9 per grantee)	Record-keeping burden (~.2 hours per grantee)	Total Reporting Burden Hours (Pre & Post Award)	Total Responses	Grand Total Burden Hours (Reporting & Record-keeeping)
A1	Child Nutrition - Team Nutrition Training Grants	State Agencies	30.00	1.00	30.00	33.58	1,007.49	240.00	192.51	1,200.00	1.00	4.00	14.00	5.00	14.00	28.00	9.00	0.23	1,228.00	288.00	1,228.23
A2	Child Nutrition – Direct Certification Grants (Assumes quarterly RFA release)	State agencies	48.00	1.00	48.00	33.58	1,611.98	384.00	308.02	1,920.00	48.00	192.00	672.00	240.00	672.00	1,344.00	432.00	10.80	3,264.00	1,296.00	3,274.80
A3	Child Nutrition – Administrative Review & Training Grants	State agencies	6.00	1.00	6.00	33.58	201.50	48.00	38.50	240.00	6.00	24.00	84.00	30.00	84.00	168.00	54.00	1.35	408.00	162.00	409.35
A4	Child Nutrition – Farm to School Grants	State, Local, & Tribal Government Agencies	195.00	1.00	195.00	53.58	10,448.69	1,560.00	1,251.32	11,700.00	44.00	176.00	616.00	220.00	616.00	1,232.00	396.00	9.90	12,932.00	2,547.00	12,941.90
A5	Child Nutrition – Professional Standard School Food Training Grants	State Agencies	30.00	1.00	30.00	33.58	1,007.49	240.00	192.51	1,200.00	1.00	4.00	14.00	5.00	14.00	28.00	9.00	0.23	1,228.00	288.00	1,228.23
A6	Food Distribution  Program – Nutrition Education Grants	State & Tribal Government Agencies	30.00	1.00	30.00	53.58	1,607.49	240.00	192.51	1,800.00	20.00	80.00	280.00	100.00	280.00	560.00	180.00	4.50	2,360.00	630.00	2,364.50
A7	Supplemental Nutrition Assistance Program – Farmers’ Market SNAP Support Grants	State, Local, & Tribal Government Agencies	20.00	1.00	20.00	23.58	471.66	160.00	128.34	600.00	10.00	40.00	140.00	50.00	140.00	280.00	90.00	2.25	880.00	360.00	882.25
A8	Supplemental Nutrition Assistance Program – Process and Technology Improvement	State, Local, & Tribal Government Agencies	15.00	1.00	15.00	33.58	503.75	120.00	96.26	600.00	7.00	28.00	98.00	35.00	98.00	196.00	63.00	1.58	796.00	261.00	797.58
A9	Supplemental Nutrition Assistance Program – Recipient Integrity Grants	State & Local Agency	10.00	1.00	10.00	38.58	385.83	80.00	64.17	450.00	3.00	12.00	42.00	15.00	42.00	84.00	27.00	0.68	534.00	144.00	534.68
A10	Special Supplemental Nutrition Program for Women, Infants and Children – Special Projects and Concept Papers	State Agency	15.00	1.00	15.00	53.58	803.75	120.00	96.26	900.00	8.00	32.00	112.00	40.00	112.00	224.00	72.00	1.80	1,124.00	279.00	1,125.80
Subtotal for State, Local & Tribal Government Agencies			524.00	0.76	399.00	45.24	18,049.62	3,192.00	2,560.38	20,610.00	203.00	592.00	2,072.00	740.00	2,072.00	4,144.00	1,332.00	33.30	24,754.00	6,255.00	24,787.30
A4	Child Nutrition – Farm to School Grants	Businesses	160.00	1.00	160.00	59.33	9,600.00	1,440.00	1,066.72	10,666.72	36.00	144.00	504.00	180.00	504.00	1,008.00	324.00	8.10	11,674.72	2,248.00	11,682.82
A7	Supplemental Nutrition Assistance Program – Farmers’ Market SNAP Support Grants	Businesses (for profit, not-for profit, farms)	80.00	1.00	80.00	29.33	2,400.00	720.00	533.36	2,933.36	15.00	60.00	210.00	75.00	210.00	420.00	135.00	3.38	3,353.36	1,070.00	3,356.74
A8	Supplemental Nutrition Assistance Program – Process and Technology Improvement	Businesses	15.00	1.00	15.00	39.33	600.00	135.00	100.01	700.01	4.00	16.00	56.00	20.00	56.00	112.00	36.00	0.90	812.01	222.00	812.91
Subtotal for Businesses			305.00	0.84	255.00	49.41	12,600.00	2,295.00	1,700.09	14,300.09	75.00	220.00	770.00	275.00	770.00	1,540.00	495.00	12.38	15,840.09	3,540.00	15,852.46
Grand Total			829.00	0.79	654.00	46.86	30,649.62	5,487.00	4,260.47	34,910.09	278.00	812.00	2,842.00	1,015.00	2,842.00	5,684.00	1,827.00	45.68	40,594.09	9,795.00	40,639.76
																			3 Year Total Requested:	30,000.00	150,000.00
																			Total Used:	9,795.00	40,639.76
																			Total Remaining:	20,205.00	109,360.24

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Sheet 2: Forms Burden Detail

Pre-Award Forms	Form Name	OMB Control No.	1 Applicant (Respondent)	Freq. of Response per RFA	Response per RFA	Time per response	Burden per RFA	Total SLT Responses per form	Total SLT Hours per Form	Total Business Responses per form	Total Business Burden per form
AD-3030	Corporate Felony Convictions and Corporate Federal Tax Delinquencies	0505-0025	1	1	1	0.25	0.25	0	0	255.00	63.75
AD-1047	Certification Regarding Debarment, Suspension, and Other Responsibility Matters Primary Covered Transactions	0505-0027	1	1	1	0.25	0.25	399.00	99.75	255.00	63.75
AD-1048	Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion Lower Tier Covered Transactions	0505-0027	1	1	1	0.25	0.25	399.00	99.75	255.00	63.75
AD-1049*	Certification Regarding Drug-Free Workplace Requirements (Grants) Alternative I – For Grantees Other Than Individuals	0505-0027	1	1	1	0.25	0.25	399.00	99.75	255.00	63.75
AD-1052*	Certification Regarding Drug-Free Workplace State and State Agencies	0505-0027	1	1	1	0.25	0.25	399.00	99.75	255.00	63.75
SF-424	Application and Instruction for Federal Assistance	4040-0004	1	1	1	1	1	399.00	399.00	255.00	255.00
SF-424A	Budget Information for Non-Construction Programs	4040-0006	1	1	1	3	3	399.00	1,197.00	255.00	765.00
SF-424B	Assurances for Non-Construction Programs	4040-0007	1	1	1	0.25	0.25	399.00	99.75	255.00	63.75
SF-424 R&R	Application for Federal Assistance (SF-424) Research & Related Projects	4040-0001	1	1	1	1.25	1.25	399.00	498.75	255.00	318.75
SF-LLL	Disclosure of Lobbying Activities	4040-0013	1	1	1	0.167	0.167	399.00	66.63	255.00	42.59
Total			1	9	9	0.741	6.667	3591	2660.133	2550	1763.835
*Note that applicant will submit either AD-1049 or AD-1052, but not both
Post-award Reporting & Forms	Form Name	OMB Control No.	1 Awardee (Respondent)	Freq. of Response per RFA	Response per RFA	Time per response	Burden per RFA	Total SLT Responses per form	Total SLT Burden per Form	Total Business Responses per form	Total Business Burden per form
Progress Reports (Avg 3 annually)			1	3	3	3	9	444.00	1,332.00	165.00	495.00
Final Performance Report			1	1	1	5	5	148.00	740.00	55.00	275.00
Reports Sub-total			1	4	4	3.5	14	592	2072	220	770
SF-425 Financial Report (Quarterly)	Federal Financial Report - Quarterly Report	4040-0014	1	4	4	1.5	6	592.00	888.00	220.00	330.00
SF-425 Final Report	Federal Financial Report - Final Report	4040-0014	1	1	1	8	8	148.00	1,184.00	55.00	440.00
Forms Sub-total			1	5	5	2.8	14	740	2072	275	770
Total			1	9	9	6.3	28	1332	4144	495	1540
Post Award Recordkeeping			1 Awardee (Respondent)	Freq. of Response per RFA	Response per RFA	Time per response	Burden per RFA	Total SLT Responses per form	Total SLT Burden per Form	Total Business Responses per form	Total Business Burden per form
SF-424	Application and Instruction for Federal Assistance	4040-0004	1	1	1	0.025	0.025	148.00	3.70	55.00	1.38
SF-424A	Budget Information for Non-Construction Programs	4040-0006	1	1	1	0.025	0.025	148.00	3.70	55.00	1.38
SF-424 B	Assurances for Non-Construction Programs	4040-0007	1	1	1	0.025	0.025	148.00	3.70	55.00	1.38
SF-LLL	Disclosure of Lobbying Activities	4040-0013	1	1	1	0.025	0.025	148.00	3.70	55.00	1.38
SF-425 Quarterly Financial Reporting	Federal Financial Report - Quarterly Report	4040-0014	1	4	4	0.025	0.1	592.00	14.80	220.00	5.50
SF-425 Final Report	Federal Financial Report - Final Report	4040-0014	1	1	1	0.025	0.025	148.00	3.70	55.00	1.38
Total			1	9	9	0.025	0.225	1332.000	33.300	495.000	12.375
		SLT		Business		Total
Grand total by form:	Form Name	Responses	Hours	Responses	Hours	Responses	Hours
AD-3030	Corporate Felony Convictions and Corporate Federal Tax Delinquencies	0	0	255	63.75	255	63.75
AD-1047	Certification Regarding Debarment, Suspension, and Other Responsibility Matters Primary Covered Transactions	399	99.75	255	63.75	654	163.5
AD-1048	Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion Lower Tier Covered Transactions	399	99.75	255	63.75	654	163.5
AD-1049	Certification Regarding Drug-Free Workplace Requirements (Grants) Alternative I – For Grantees Other Than Individuals	0	0	255	63.75	255	63.75
AD-1052	Certification Regarding Drug-Free Workplace, State and State Agencies	399	99.75	0	0	399	99.75
USDA Forms Burden Subtotal		1197	299.25	1020	255	2217	554.25
SF-424	Application and Instruction for Federal Assistance	547	402.7	310	256.375	857	659.075
SF-424A	Budget Information for Non-Construction Programs	547	1200.7	310	766.375	857	1967.075
SF-424B	Assurances for Non-Construction Programs	547	103.45	310	65.125	857	168.575
SF-424 R&R	Application for Federal Assistance (SF-424) Research & Related Projects	399	498.75	255	318.75	654	817.5
SF-LLL	Disclosure of Lobbying Activities	547	70.333	310	43.96	857	114.293
SF-425	Federal Financial Report	1480	2090.5	550	776.875	2030	2867.375
Standard Forms Burden Subtotal		4067	4366.433	2045	2227.46	6112	6593.893
Total		5264	4665.683	3065	2482.46	8329	7148.143