Information Collection

Specialty Crop Multi-State Program (State)

IC 223524 under ICR 201608-0581-001 · OMB 0581-0240.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0581-0240 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Specialty Crop Multi-State Program (State)	Form and Instruction
SCMP Application Components Screenshot.docx www.ams.usda.gov	Instruction
Request for Applications SCMP Request for Applications.pdf www.ams.usda.gov	Form and Instruction
Application Screening Checklist Application Screening Checklist 8-18-16.pdf www.ams.usda.gov	Form and Instruction
Registration with SAM.gov (screenshot) SAM.gov Screen Shot.pdf www.SAM.gov	Form and Instruction
Accounting System & Financial Capability Questionnaire Accounting System Financial Capability Questionnaire 8-17-16.docx www.ams.usda.gov	Form and Instruction
Project Beneficiaries Questionnaire Project Beneficiaries Questionnaire 8-17-16.docx www.ams.usda.gov	Form and Instruction
AMS-33 Agreement Face Sheet AMS-33 Agreement Face Sheet 8-17-16.pdf www.ams.usda.gov	Form and Instruction
Interim Performance Report SCMP Interim Report.pdf www.ams.usda.gov	Form and Instruction
Final Performance Report SCMP Final Report.pdf www.ams.usda.gov	Form and Instruction
AMS Worksheet to Accompany each SF-270 Request AMS Worksheet to Accompany each SF-270 Request 8-17-16.xlsx www.ams.usda.gov	Form and Instruction
Peer Reviewer Application & Qualification form Peer Reviewer Application & Qualification Form.xls www.ams.usda.gov	Form and Instruction
AMS-34 AMS Conflict of Interest & Confidentiality for Grant Rev AMS-34 AMS Conflict of Interest and Confidentiality Statement 8-17-16.pdf www.ams.usda.gov	Form and Instruction
Consensus Scoresheet & Comments Consensus Scoresheet.xlsx www.ams.usda.gov	Form and Instruction
Individual Reviewer Scoresheet Individual Reviewer Scoresheet.xlsx www.ams.usda.gov	Form and Instruction
Request for Grant Amendment Example.pdf Request for Grant Amendment (Narrative)	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Specialty Crop Multi-State Program (State)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	None	Request for Applications	SCMP Request for Applications.pdf	www.ams.usda.gov	Yes	Yes	Fillable Fileable
Form and Instruction	None	Application Screening Checklist	Application Screening Checklist 8-18-16.pdf	www.ams.usda.gov	Yes	Yes	Fillable Fileable
Form and Instruction	None	Registration with SAM.gov (screenshot)	SAM.gov Screen Shot.pdf	www.SAM.gov	Yes	Yes	Fillable Fileable
Form and Instruction	None	Accounting System & Financial Capability Questionnaire	Accounting System Financial Capability Questionnaire 8-17-16.docx	www.ams.usda.gov	Yes	Yes	Fillable Fileable
Form and Instruction	None	Project Beneficiaries Questionnaire	Project Beneficiaries Questionnaire 8-17-16.docx	www.ams.usda.gov	Yes	Yes	Fillable Fileable
Form and Instruction	AMS-33	Agreement Face Sheet	AMS-33 Agreement Face Sheet 8-17-16.pdf	www.ams.usda.gov	Yes	Yes	Fillable Fileable
Form and Instruction	None	Interim Performance Report	SCMP Interim Report.pdf	www.ams.usda.gov	Yes	Yes	Fillable Fileable
Form and Instruction	None	Final Performance Report	SCMP Final Report.pdf	www.ams.usda.gov	Yes	Yes	Fillable Fileable
Form and Instruction	None	AMS Worksheet to Accompany each SF-270 Request	AMS Worksheet to Accompany each SF-270 Request 8-17-16.xlsx	www.ams.usda.gov	Yes	Yes	Fillable Fileable
Form and Instruction	None	Peer Reviewer Application & Qualification form	Peer Reviewer Application & Qualification Form.xls	www.ams.usda.gov	Yes	Yes	Fillable Fileable
Form and Instruction	AMS-34	AMS Conflict of Interest & Confidentiality for Grant Reviewers	AMS-34 AMS Conflict of Interest and Confidentiality Statement 8-17-16.pdf	www.ams.usda.gov	Yes	Yes	Fillable Fileable
Form and Instruction	None	Consensus Scoresheet & Comments	Consensus Scoresheet.xlsx	www.ams.usda.gov	Yes	Yes	Fillable Fileable
Form and Instruction	None	Individual Reviewer Scoresheet	Individual Reviewer Scoresheet.xlsx	www.ams.usda.gov	Yes	Yes	Fillable Fileable
Instruction			SCMP Application Components Screenshot.docx	www.ams.usda.gov	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 240

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,876	2,876
Annual IC Time Burden (Hours)	6,744	6,744
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Request for Grant Amendment (Narrative)	Request for Grant Amendment Example.pdf	09/13/2016

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.