The Rural Alaska Village Grant (RAVG) Program

Forms and Documents

Document Name	Status
Form AD -1047 non-profit / private sector Form	Modified
Form AD-1047 State and Local Governments Form	Modified
0572-0150 Spreadsheet 2018 11-20-2018.xls Supplementary Document	2018-11-20
2018 0572-0150 SuptStmt 2-19-2019(Rev.3).docx Supporting Statement A	2019-02-19
UP_ET_form_266.pdf Supplementary Document	2018-09-05
SFLLL_1_2-V1.2.pdf Supplementary Document	2018-09-05
Individual_SF424D-V1.1.pdf Supplementary Document	2018-09-05
SF424C_2_0-V2.0.pdf Supplementary Document	2018-09-05
Individual_SF424B-V1.1.pdf Supplementary Document	2018-09-05
SF424_2_1-V2.1.pdf Supplementary Document	2018-09-05

IC Document Collections

IC ID	Document Title	Status
209670	non-profit / private sector Form	Modified
209668	State and Local Governments Form	Modified

ICR Details

OMB Control No: 0572-0150	ICR Reference No: 201809-0572-001
Status: Active	Previous ICR Reference No: 201507-0572-001
Agency/Subagency: USDA/RUS	Agency Tracking No:
Title: The Rural Alaska Village Grant (RAVG) Program
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 02/19/2019
	Date Received in OIRA: 11/26/2018
Terms of Clearance: In accordance with 5 CFR 1320, the information collection is approved for three years.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2022	36 Months From Approved	02/28/2019
Responses	345	0	345
Time Burden (Hours)	469	0	469
Cost Burden (Dollars)	0	0	0

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Abstract: The RAVG regulations are at 7 CFR Part 1784. Under the RAVG program, the Secretary may make grants to the State of Alaska for the benefit of rural or Native Villages in Alaska to provide for the development and construction of water and wastewater systems to improve the health and sanitation conditions in those villages. This collection involves the information collected from applicants, grantees, and consultants to the program.

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Authorizing Statute(s): US Code: 7 USC 1926(d) Name of Law: Consolidated Farm and Rural Development Act (CONACT)
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 24457	05/28/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 59355	11/23/2018
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
non-profit / private sector	AD -1047, AD- 1048, AD - 1049, RD Instruction 1940Q A-1, RD 400-1, RD 400-4, RD 442-22, None, RUS Bulletin 1780-12, RD 1942-46, SF 424, None	Certification Regarding Debarment ,   Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Transaction ,   Certification Regarding Drug-Free Workplace ,   Certification for Contracts, Grants and Loans REgarding Lobbying ,   Equal Opportunity Agreement ,   Assurance Agreement ,   Opinion of COunsel relative to RIght-of-Way & Easments ,   Letter of Intent to Meet Conditions ,   Application for Federal Assistance ,   RUS Bulletin 1780-12 ,   RAVG SOA Grant Agreement ,   RAVG ANTHC Grant Agreement
State and Local Governments	AD-1047, AD-1048, RD Instruction 1940Q A-1, RD 400-1, RD 400-4, RD 442-22, RD 1942-46, SF 424, None, RUS Bulletin 1780-12, None, AD-1049	Certificate Regarding Debarment ,   Certification Regarding Debarment, Suspension and other Responsibility Matters - Lower Tier Covered Transactions. ,   Certification Regarding Drug-Free Workplace Requirements (Grrants) Alternative I - for Grantees Other Than Individuals ,   Certification for Contracts, Grants, and Loans ,   Equal opportunity Agreement ,   Assurance Agreement ,   Opinion of Counsel Regarding Right of Way ,   Letter of Intent to Meet Conditions ,   Application for Federal Assistance ,   RUS Bulletin 1780-12 ,   RAVG ANTHC Grant Agreement ,   RAVG SOA Grant Agreement

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	345	345	0	0	0	0
Annual Time Burden (Hours)	469	469	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $878,691

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 11/26/2018

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