HPG Burden Summary Spreadsheet

ROCIS(rev.3)_ HPG 0575-0115 SpreadSheet (Rev3) mpd)4-22-2019.docx

7 CFR Part 1944-N "Housing Preservation Grants"

HPG Burden Summary Spreadsheet

OMB: 0575-0115

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7 CFR 1944-N “Housing Preservation Grant”

OMB No. 0575-0115



Reports Filed: Annually/Semi-Annually/Quarterly

Date Prepared: November 30, 2018


Section of

Regulation


(A)


Title



(B)


Form

Number


(C)

Estimated

No. of

Respondents


(D)

Reports Filed

Annually


(E)

Total

Annual

Responses

(D) x (E)

(F)

Hours

Per

Response


(G)

Total

Annual

Hours

(F) x (G)

(H)

Wage

Class

(per hour)


(I)

Cost to the

Public

(H) x (I)


(J)

REPORTING REQUIREMENTS – NO FORMS


1944.651(d)


Applicants must inform Agency if there

is any known relationship of association with a RHS employee.


- Local/State Governments

(Native American Indian Tribes)


- Nonprofit organization


Narrative










2



3






1



1






2



3






0.16



0.16






1



1






$16.00



$16.00






$16.00



$16.00


1944.658(a)(3)

1944.666(b)(7)

1944.666(e)

1944.670(a)

1944.676(b)(1)(x)

1944.688(e)

1944.689(a)(3)


7 CFR 3015, 7 CFR 3016, and

OMB Circular A-122


- Local/State Governments

(Native American Indian Tribes)


- Nonprofit organization


Narrative









43



58





1



1





43



58





8



8





344



464





$16.00



$16.00





$5,504



$7,424


1944.661(a)

1944.661(b)


HPG recipient (individual Homeowners)

evidence of income and ownership


- Local/State Governments

(Native American Indian Tribes)


- Nonprofit organization


Grantee form

documentation









460



633





2



2





920



1,266





1



1





920



1,266





$16.00



$16.00





$14,720



$20,256


1944.662(a)



HPG recipient (rental property owner or

Co-op) requirements of evidence of

ownership


- Local/State Governments

(Native American Indian Tribes)


- Nonprofit organization


Grantee form

documentation










43



58






1



1






43



58






0.5



0.5






22



29






$16.00



$16.00






$352



$464

7 CFR 1944-N “Housing Preservation Grant”

OMB No. 0575-0115



Reports Filed: Annually/Semi-Annually/Quarterly

Date Prepared: November 30, 2018


Section of

Regulation


(A)


Title



(B)


Form

Number


(C)

Estimated

No. of

Respondents


(D)

Reports Filed

Annually


(E)

Total

Annual

Responses

(D) x (E)

(F)

Hours

Per

Response


(G)

Total

Annual

Hours

(F) x (G)

(H)

Wage

Class

(per hour)


(I)

Cost to the

Public

(H) x (I)


(J)

REPORTING REQUIREMENTS – NO FORMS


1944.662(b)


HPG recipient (tenant in rental property or co-op owner) of income eligibility


- Local/State Governments

(Native American Indian Tribes)


- Nonprofit organization


Grantee from

and/or

documentation









460



633





1



1





460



633





0.5



0.5





230



317





$16.00



$16.00





$3,680



$5,072


1944.663


Ownership agreement between HPG

Grantee and Rental Property Owner or

Co-op


- Local/State Governments

(Native American Indian Tribes)


- Nonprofit organization


Non-standard

form by

grantee










22



31






1



1






22



31






1



1






22



31






$16.00



$16.00






$352



$496


1944.665



Final Inspection Report


- Local/State Governments

(Native American Indian Tribes)


- Nonprofit organization


Non-standard








460



633




1



1




460



633




0.5



0.5




230



317




$16.00



$16.00




$3,680



$5,072


1944.667



Relocation and displacement


- Local/State Governments

(Native American Indian Tribes)


- Nonprofit organization


Narrative in

statement of

activities








43



58


1



1




43



58




0.33



0.33




14



19




$16.00



$16.00




$224



$304



7 CFR 1944-N “Housing Preservation Grant”

OMB No. 0575-0115



Reports Filed: Annually/Semi-Annually/Quarterly

Date Prepared: November 30, 2018


Section of

Regulation


(A)


Title



(B)


Form

Number


(C)

Estimated

No. of

Respondents


(D)

Reports Filed

Annually


(E)

Total

Annual

Responses

(D) x (E)

(F)

Hours

Per

Response


(G)

Total

Annual

Hours

(F) x (G)

(H)

Wage

Class

(per hour)


(I)

Cost to the

Public

(H) x (I)


(J)

REPORTING REQUIREMENTS – NO FORMS


1944.672(e)

1944.673

1944.676(d)(e)


Documentation of historic preservation

process, determination if unit is located in floodplain/wetland, or an archeological property


- Local/State Governments

(Native American Indian Tribes)


- Nonprofit organization


Narrative and

Exhibit F-2











460



633







1



1







460



633







0.16



0.16







74



101







$16.00



$16.00







$1,184



$1,616


1944.674(c)

1944.676(e-g)


Documentation that statement of activities submitted to State single point of contact


- Local/State Governments

(Native American Indian Tribes)


- Nonprofit organization


Narrative










88



122






1



1






88



122






0.16



0.16






11



21






$16.00



$16.00






$224



$320


1944.676(b)



Statement of Activities (Pre-application Requirement)


- Local/State Governments

(Native American Indian Tribes)


- Nonprofit organization


Narrative









88



122





1



1





88



122





8



8





704



976





$16.00



$16.00





$11,264



$15,616


1944.683(b)

1944.688(a)



Quarterly and Final Performance Reports


- Local/State Governments

(Native American Indian Tribes)


- Nonprofit organization


Exhibit E-1









43



58





4



4





172



232





2



2





344



464





$16.00



$16.00





$5,504



$7,424


7 CFR 1944-N “Housing Preservation Grant”

OMB No. 0575-0115



Reports Filed: Annually/Semi-Annually/Quarterly

Date Prepared: November 30, 2018



Section of

Regulation


(A)


Title



(B)


Form

Number


(C)

Estimated

No. of

Respondents


(D)

Reports Filed

Annually

(D) x (E)

(E)

Total

Annual

Responses

(D) x (E)

(F)

Hours

Per

Response


(G)

Total

Annual

Hours

(F) x (G)

(H)

Wage

Class

(per hour)


(I)

Cost to the

Public

(H) x (I)


(J)



1944.684(d)


Amendment to Grant Agreement

Extension and/or Revision


- Local/State Governments

(Native American Indian Tribes)


- Nonprofit organization



Exhibit B









21



23





1



1





21



23





0.5



0.5





11



12





$16.00



$16.00





$176



$192



REPORTING REQUIREMENTS – FORMS













1944.654(b)


Certification Regarding Drug-Free

Workplace Requirements (Grants)

Alternative I – for Grantees Other Than

Individuals


- Local/State Governments

(Native American Indian Tribes)


- Nonprofit organization



AD 1049











88



122







1



1







88



122







0.25



0.25







22



31







$16.00



$16.00







$352



$496





REPORTING TOTAL (Burden)






6,904



6,998







7 CFR 1944-N “Housing Preservation Grant”

OMB No. 0575-0115



Reports Filed: Annually/Semi-Annually/Quarterly

Date Prepared: November 30, 2018


Section of

Regulation


(A)


Title



(B)


Form

Number


(C)

Estimated

No. of

Respondents


(D)

Reports Filed

Annually


(E)

Total

Annual

Responses

(D) x (E)

(F)

Hours

Per

Response


(G)

Total

Annual

Hours

(F) x (G)

(H)

Wage

Class

(per hour)


(I)

Cost to the

Public

(H) x (I)

(J)

BURDENS AND FORMS APPROVED UNDER OTHER OMB NUMBERS


1944.682{c)


Request for Advance or Reimbursement


- Local/State Governments

(Native American Indian Tribes)


- Nonprofit organization


SF 270

(0348-0004)






43



58





4



4





172



232





0.5



0.5





86



116





$16.00



$16.00





$1,376



$1,856


1944.683(a-b)



Financial Status Report


- Local/State Governments

(Native American Indian Tribes)


- Nonprofit organization


SF 425

(4040-0014)








43



58




4



4




172



232




0.5



0.5




86



116




$16.00



$16.00




$1,376



$1,856


1944.672(a)

1944.676(c)


Environmental Report


- Local/State Governments

(Native American Indian Tribes)


- Nonprofit organization


Written

(0575-0197)








88



122




1



1




88



122




6



6




528



732




$16.00



$16.00




$8,448



$11,712


1944.676{a)


Pre-Application for Federal Assistance


- Local/State Governments

(Native American Indian Tribes)


- Nonprofit organization


SF 424

(4040-0004)






88


122





1


1





88


122





0.5


0.5





44


61





$16.00


$16.00





$704


$976





7 CFR 1944-N “Housing Preservation Grant”

OMB No. 0575-0115



Reports Filed: Annually/Semi-Annually/Quarterly

Date Prepared: November 30, 2018


Section of

Regulation


(A)


Title



(B)


Form

Number


(C)

Estimated

No. of

Respondents


(D)

Reports Filed

Annually


(E)

Total

Annual

Responses

(D) x (E)

(F)

Hours

Per

Response


(G)

Total

Annual

Hours

(F) x (G)

(H)

Wage

Class

(per hour)


(I)

Cost to the

Public

(H) x (I)

(J)


1944.676(h)


Equal Opportunity Agreement


- Local/State Governments

(Native American Indian Tribes)


- Nonprofit organization


Form RD 400-1

(0575-0018)








88



122




1



1




88



122




0.16



0.16




22



31




$16.00



$16.00




$224



$320


1944.676(h)



Assurance Agreement


- Local/State Governments

(Native American Indian Tribes)


- Nonprofit organization


Form RD 400-4

(0575-0018)





88



122




1



1




88



122




.25



.25




22



31




$16.00



$16.00




$352



$496


1944.681


Application for Federal Assistance


- Local/State Governments

(Native American Indian Tribes)


- Nonprofit organization


SF 424

(4040-0004)









43


58





1


1





43


58





0.5


0.5





22


29





$16.00


$16.00





$352


$464






7 CFR 1944-N “Housing Preservation Grant”

OMB No. 0575-0115



Reports Filed: Annually/Semi-Annually/Quarterly

Date Prepared: November 30, 2018


Section of

Regulation


(A)


Title



(B)


Form

Number


(C)

Estimated

No. of

Respondents


(D)

Reports Filed

Annually


(E)

Total

Annual

Responses

(D) x (E)

(F)

Hours

Per

Response


(G)

Total

Annual

Hours

(F) x (G)

(H)

Wage

Class

(per hour)


(I)

Cost to the

Public

(H) x (I)

(J)


1944.682(c)


Federal Cash Transactions Report


- Local/State Governments

(Native American Indian Tribes)


- Nonprofit organization


SF 272

(0348-0003)








43



58




4



4




172



232




0.5



0.5




86



116




$16.00



$16.00




$1,376



$1,856

RECORDKEEPING REQUIREMENTS (under this collection)


1944.682(a)



Grant Agreement


- Local/State Governments

(Native American Indian Tribes)


- Nonprofit organization


Exhibit A





43



58




1



1




43



58




0.5



0.5




22



29




$16.00



$16.00




$352



$464



RECORDKEEPING TOTAL






101



51



816













REPORTING TOTAL






6,904



6,998





TOTAL BURDEN

for this Collection






7,005



7,049



127,232



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