| USDA - RUS |
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Title of Information Document |
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OMB No. |
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0572-0127 |
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| SUMMARY OF INFORMATION COLLECTION |
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Broadband Grant Program |
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Date Prepared |
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09/07/16 |
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| INSTRUCTIONS: |
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> |
(f) TOTAL |
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(h) TOTAL |
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(k) TOTAL |
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| Use this form when a single information collection document involves multiple reporting and |
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> |
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= (e) Average |
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= (g) Average |
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= (j) Average |
| recordkeeping requirements. |
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(d) TOTAL |
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(f) TOTAL |
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(i) TOTAL |
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| IDENTIFICATION OF REPORTING AND RECORDKEEPPING REQUIREMENTS |
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ANNUAL BURDEN |
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FORM |
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REPORTS |
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RECORDS |
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NO(s) |
NO. OF |
NO. OF |
TOTAL |
HOURS |
TOTAL |
NO. OF |
ANNUAL |
TOTAL |
| SECTION OF |
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(If "none" |
RESPON- |
RESPONSES |
ANNUAL |
PER |
HOURS |
RECORD- |
HOURS PER |
RECORD- |
| REGULATIONS |
DESCRIPTION |
so state) |
DENTS |
PER |
RESPONSES |
RESPONSE |
(Col. f & g) |
KEEPERS |
RECORD- |
KEEPING |
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RESPON- |
(Col. d & e) |
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KEEPER |
HOURS |
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DENT |
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(Col. i & j) |
| (a) |
(b) |
(c) |
(d) |
(e) |
(f) |
(g) |
(h) |
(i) |
(j) |
(k) |
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Application |
none |
70 |
1 |
70 |
160.0 |
11,200 |
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Grant Agreement / Certificate of Authority |
none |
9 |
1 |
9 |
20.0 |
180 |
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Application for Federal Assistance (Reported as RCF for burden hours under 4040-0005) |
SF-424 |
70 |
1 |
70 |
1.0 |
70 |
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79 |
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11,380 |
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| RUS Form 36 (07-91) |
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