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7 CFR 1778, Emergency and Imminent Community Water Assistance Grants (non-profit)
7 CFR 1778, Emergency and Imminent Community Water Assistance Grants
OMB: 0572-0110
IC ID: 178410
OMB.report
USDA/RUS
OMB 0572-0110
ICR 201902-0572-003
IC 178410
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0572-0110 can be found here:
2022-11-03 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form AD 1047
7 CFR 1778, Emergency and Imminent Community Water Assistance Grants (non-profit)
Form
AD 1047 Certification Regarding Debarment, Suspension, and Other
AD-1047.pdf
Form
AD-1048 Certification Regarding Debarment, Suspension, Ineligibi
AD-1048.pdf
Form
AD-1049 Certification Regarding Drug-Free Workplace Requirements
AD-1049.pdf
Form
RD 400-8 Compliance Review
RD 400-8.pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
7 CFR 1778, Emergency and Imminent Community Water Assistance Grants (non-profit)
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 1778
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
AD 1047
Certification Regarding Debarment, Suspension, and Other Responsibility Matters
AD-1047.pdf
Yes
Yes
Fillable Printable
Form
AD-1048
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion
AD-1048.pdf
Yes
Yes
Fillable Printable
Form
AD-1049
Certification Regarding Drug-Free Workplace Requirements (Grants)
AD-1049.pdf
Yes
Yes
Fillable Printable
Form
RD 400-8
Compliance Review
RD 400-8.pdf
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Economic Development
Subfunction:
Business and Industry Development
Privacy Act System of Records
Title:
NA
FR Citation:
7 FR 1778
Number of Respondents:
26
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
0 %
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
210
0
0
110
0
100
Annual IC Time Burden (Hours)
1,462
0
0
1,262
0
200
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.