|
|
|
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 |
|
| 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 |
|
|
|
|
|