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Technical Assistance Program - Private Sector
Technical Assistance Program - 7 CFR 1775
OMB: 0572-0112
IC ID: 1830
OMB.report
USDA/RUS
OMB 0572-0112
ICR 201705-0572-001
IC 1830
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0572-0112 can be found here:
2020-11-23 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form AD-1047
Technical Assistance Program - Private Sector
Form and Instruction
AD-1047 Certification Regarding Debarment, Suspension, and Other
AD_1047-V1.0.pdf
www.grants.gov/web/grants/forms/sf-424-family.html#sortby=1
Form and Instruction
AD-1048 Certification Regarding Debarment, Suspension, Ineligibi
AD_1048-V1.0.pdf
www.grants.gov/web/grants/forms/sf-424-family.html#sortby=1
Form and Instruction
AD-1049 Certification Regarding Drug-Free Workplace Requirements
AD_1049-V1.0.pdf
www.grants.gov/web/grants/forms/sf-424-family.html#sortby=1
Form and Instruction
AD-3030 REPRESENTATIONS REGARDING FELONY CONVICTION
AD_3030_1_1-V1.1.pdf
www.grants.gov/web/grants/forms/sf-424-family.html#sortby=1
Form and Instruction
AD-3031 ASSURANCE REGARDING FELONY CONVICTION
AD_3031_1_1-V1.1.pdf
www.grants.gov/web/grants/forms/sf-424-family.html#sortby=1
Form and Instruction
SF-LLL DISCLOSURE OF LOBBYING ACTIVITIES
SFLLL_1_2_P-V1.2.pdf
www.grants.gov/web/grants/forms/post-award-reporting-forms.html#sortby=1
Form and Instruction
SF-424 Application for Federal Assistance
SF424_2_1-V2.1.pdf
www.grants.gov/web/grants/forms/sf-424-family.html#sortby=1
Form and Instruction
SF-424B Assurances - Non-Construction Programs
SF424B-V1.1.pdf
www.grants.gov/web/grants/forms/sf-424-family.html#sortby=1
Form and Instruction
SF 270 Request For Advance or Reimbursement
SF270-V1.0.pdf
www.grants.gov/web/grants/forms/post-award-reporting-forms.html#sortby=1
Form and Instruction
SF 425 Federal Financial Assistance
SF425-V1.0.pdf
www.grants.gov/web/grants/forms/post-award-reporting-forms.html#sortby=1
Form and Instruction
SF-424A Budget Information - Non-Construction Programs
SF424A-V1.0.pdf
www.grants.gov/web/grants/forms/sf-424-family.html#sortby=1
Form and Instruction
CFR-2014-title7-vol12-part1775.pd.pdf
CFR - Title 7 part 1775
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Technical Assistance Program - Private Sector
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
7 CFR 1775
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
AD-1047
Certification Regarding Debarment, Suspension, and Other Responsibility Matters
AD_1047-V1.0.pdf
https://www.grants.gov/web/grants/forms/sf-424-family.html#sortby=1
Yes
Yes
Fillable Fileable Signable
Form and Instruction
AD-1048
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion
AD_1048-V1.0.pdf
https://www.grants.gov/web/grants/forms/sf-424-family.html#sortby=1
Yes
Yes
Fillable Fileable Signable
Form and Instruction
AD-1049
Certification Regarding Drug-Free Workplace Requirements (Grants)
AD_1049-V1.0.pdf
https://www.grants.gov/web/grants/forms/sf-424-family.html#sortby=1
Yes
Yes
Fillable Fileable Signable
Form and Instruction
AD-3030
REPRESENTATIONS REGARDING FELONY CONVICTION
AD_3030_1_1-V1.1.pdf
https://www.grants.gov/web/grants/forms/sf-424-family.html#sortby=1
Yes
Yes
Fillable Fileable Signable
Form and Instruction
AD-3031
ASSURANCE REGARDING FELONY CONVICTION
AD_3031_1_1-V1.1.pdf
https://www.grants.gov/web/grants/forms/sf-424-family.html#sortby=1
Yes
Yes
Fillable Fileable Signable
Form and Instruction
SF-LLL
DISCLOSURE OF LOBBYING ACTIVITIES
SFLLL_1_2_P-V1.2.pdf
https://www.grants.gov/web/grants/forms/post-award-reporting-forms.html#sortby=1
Yes
Yes
Fillable Fileable Signable
Form and Instruction
SF-424
Application for Federal Assistance
SF424_2_1-V2.1.pdf
https://www.grants.gov/web/grants/forms/sf-424-family.html#sortby=1
Yes
Yes
Fillable Fileable Signable
Form and Instruction
SF-424B
Assurances - Non-Construction Programs
SF424B-V1.1.pdf
https://www.grants.gov/web/grants/forms/sf-424-family.html#sortby=1
Yes
Yes
Fillable Fileable Signable
Form and Instruction
SF 270
Request For Advance or Reimbursement
SF270-V1.0.pdf
https://www.grants.gov/web/grants/forms/post-award-reporting-forms.html#sortby=1
Yes
Yes
Fillable Fileable Signable
Form and Instruction
SF 425
Federal Financial Assistance
SF425-V1.0.pdf
https://www.grants.gov/web/grants/forms/post-award-reporting-forms.html#sortby=1
Yes
Yes
Fillable Fileable Signable
Form and Instruction
SF-424A
Budget Information - Non-Construction Programs
SF424A-V1.0.pdf
https://www.grants.gov/web/grants/forms/sf-424-family.html#sortby=1
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:
66
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
2 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,211
0
0
-503
0
1,714
Annual IC Time Burden (Hours)
5,095
0
0
-932
0
6,027
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
CFR - Title 7 part 1775
CFR-2014-title7-vol12-part1775.pd.pdf
06/01/2017
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.