Information Collection

A4- Direct Certification RFA (SLT)

IC 235881 under ICR 202008-0584-002 · OMB 0584-0512.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0512 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form AD-1047 DebarmentCert-PrimaryCovered A4- Direct Certification RFA (SLT)	Form
Form AD-1048 DebarmentCert-LowerTierCovered A4- Direct Certification RFA (SLT)	Form
Form AD-1049 DrugFreeCert-Alt1 4-2022.pdf A4- Direct Certification RFA (SLT)	Form
Form AD-1050 DrugFreeCert-Alt2 - 4-2022.pdf A4- Direct Certification RFA (SLT)	Form
Form AD-1052 DrugFreeCert-FedFY 4-2022.pdf A4- Direct Certification RFA (SLT)	Form
Form SF 425 Screenshots FederalFinancialReport A4- Direct Certification RFA (SLT)	Form
Form SF 425 FederalFinancialReport A4- Direct Certification RFA (SLT)	Form
Form FNS 906 GRANT PROGRAM ACCOUNTING SYSTEM & FINANCIAL CAPABILITY QUESTIONNAIRE A4- Direct Certification RFA (SLT)	Form
Form FNS 908 REVISED 8- PERFORMANCE PROGRESS REPORT A4- Direct Certification RFA (SLT)	Form
Attachment A4 CN Direct Certification Template 7-10-19.docx	Other-Request for Application Templa
AD-1047 DebarmentCert-PrimaryCovered AD-1047 DebarmentCert-PrimaryCovered 4-2022.pdf	Form
AD-1048 DebarmentCert-LowerTierCovered AD-1048 DebarmentCert-LowerTierCovered 4-2022.pdf	Form
AD-1049 DrugFreeCert-Alt1 4-2022.pdf AD-1049 DrugFreeCert-Alt1 4-2022.pdf	Form
AD-1050 DrugFreeCert-Alt2 - 4-2022.pdf AD-1050 DrugFreeCert-Alt2 - 4-2022.pdf	Form
AD-1052 DrugFreeCert-FedFY 4-2022.pdf AD-1052 DrugFreeCert-FedFY 4-2022.pdf	Form
SF 425 Screenshots FederalFinancialReport SF-425 Screenshots.pdf	Form
SF 425 FederalFinancialReport SF425_2_0-V2.0 exp 2-2022.pdf	Form
FNS 906 GRANT PROGRAM ACCOUNTING SYSTEM & FINANCIAL CAPABILITY Q FNS-906.pdf	Form
FNS 908 REVISED 8- PERFORMANCE PROGRESS REPORT FNS-908_v1.3 (8-11-2020).pdf	Form
Award Terms and Conditions - Generic - 2.21.2019.docx Award Terms and Conditions - Generic - 2.21.2019.docx	IC Document
AD_3030_2_0-V2.0.pdf AD 3030	IC Document
SF424_2_1-V2.1.pdf SF 424	IC Document
SF424A-V1.0.pdf SF 424A	IC Document
SF424B-V1.1.pdf SF 424B	IC Document
SF424C_2_0-V2.0.pdf SF 424C	IC Document
SF424D-V1.1.pdf SF 424D	IC Document
SFLLL_1_2-V1.2.pdf SF LLL	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

A4- Direct Certification RFA (SLT)

Agency IC Tracking Number:

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Request for Application Template		www.grants.gov	Yes	Yes	Fillable Fileable Signable
Form	AD-1047	www.grants.gov	Yes	Yes	Fillable Fileable Signable
Form	AD-1048	www.grants.gov	Yes	Yes	Fillable Fileable Signable
Form	AD-1049	www.grants.gov	Yes	Yes	Fillable Fileable Signable
Form	AD-1050	www.grants.gov	Yes	Yes	Fillable Fileable Signable
Form	AD-1052	www.grants.gov	Yes	Yes	Fillable Fileable Signable
Form	SF 425 Screenshots	www.fprs.gov	Yes	Yes	Fillable Fileable Signable
Form	SF 425	www.grants.gov	Yes	Yes	Fillable Fileable Signable
Form	FNS 906	www.grants.gov	Yes	Yes	Fillable Fileable Signable
Form	FNS 908 REVISED 8-12-2020	www.grants.gov	Yes	Yes	Fillable Fileable Signable

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title: USDA e-Authentication Service

FR Citation: 77 FR 15024

Number of Respondents: 48

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	1,296	1,296
Annual IC Time Burden (Hours)	3,275	3,275
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Award Terms and Conditions - Generic - 2.21.2019.docx		05/07/2019
AD 3030		05/30/2019
SF 424		05/30/2019
SF 424A		05/30/2019
SF 424B		05/30/2019
SF 424C		05/30/2019
SF 424D		05/30/2019
SF LLL		05/30/2019

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

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