Information Collection

Value-Added Producer Grants - Business

IC 194172 under ICR 201812-0570-001 · OMB 0570-0064.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0570-0064 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form AD 1047 Value-Added Producer Grants - Business	Form
AD 1047 Certification Regarding Debarment, Suspension and Other AD_1047.pdf	Form
AD 1048 Certification Regarding Debarment, Suspension, Inelgibli AD_1048.pdf	Form
AD 1049 Certification Regarding Drug-Free Workplace Requirements AD_1049.pdf	Form
RD 400-4 Assurance Agreement RD 400-4.pdf	Form
RD 1942-46 Letter of Intent to Meet Conditions RD1942-46.pdf	Form
RD 1940-1 Request for Obligation of Funds RD1940-1.pdf	Form
4280-2 Rural Business Cooperative Service Grant Agreement 4280-02.doc	Form

IC Title:

Value-Added Producer Grants - Business

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 4284

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	AD 1047	Certification Regarding Debarment, Suspension and Other Responsibility Matters - Primary Covered Transaction	AD_1047.pdf	Yes	No	Fillable Printable
Form	AD 1048	Certification Regarding Debarment, Suspension, Inelgiblity and Voluntary Exclusion - Lower Tier Covered Tranaction	AD_1048.pdf	Yes	No	Fillable Printable
Form	AD 1049	Certification Regarding Drug-Free Workplace Requirements (Grants) Alternative I - For Grantees Other Than Individuals	AD_1049.pdf	Yes	No	Fillable Printable
Form	RD 400-4	Assurance Agreement	RD 400-4.pdf	Yes	No	Fillable Printable
Form	RD 1942-46	Letter of Intent to Meet Conditions	RD1942-46.pdf	Yes	No	Fillable Printable
Form	RD 1940-1	Request for Obligation of Funds	RD1940-1.pdf	Yes	No	Fillable Printable
Form	4280-2	Rural Business Cooperative Service Grant Agreement	4280-02.doc	Yes	No	Fillable Printable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 500

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Farms, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 10 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	3,208	-86	3,294
Annual IC Time Burden (Hours)	47,536	-1,513	49,049
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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