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pdfPAPERWORK REDUCTION ACT SUBMISSION
Please read the instructions before completing this form. For additional forms or assistance in completing this form, contact your
agency's Paperwork Clearance Officer. Send two copies of this form, the collection instrument to be reviewed, the Supporting
Statement, and any additional documentation to: Office of Information and Regulatory Affairs, Office of Management and Budget,
Docket Library, Room 10102, 725 17th Street NW, Washington, DC 20503.
2. OMB CONTROL NUMBER
1. AGENCY/SUBAGENCY ORIGINATING REQUEST
Rural Utilities Service (RUS)
a.
4. TYPE OF REVIEW REQUESTED (X one)
3. TYPE OF INFORMATION COLLECTION (X one)
(For b. - f., note Item A2 of Supporting Statement instructions)
X
a. NEW COLLECTION
X
b. NONE
0157
0572
a. REGULAR SUBMISSION
b. EMERGENCY - APPROVAL REQUESTED BY:
b. REVISION OF A CURRENTLY APPROVED COLLECTION
c. DELEGATED
c. EXTENSION OF A CURRENTLY APPROVED COLLECTION
d. REINSTATEMENT, WITHOUT CHANGE, OF A PREVIOUSLY
APPROVED COLLECTION FOR WHICH APPROVAL HAS EXPIRED
5. SMALL ENTITIES
Will this information collection have a significant economic
impact on a substantial number of small entities?
e. REINSTATEMENT, WITH CHANGE, OF A PREVIOUSLY
APPROVED COLLECTION FOR WHICH APPROVAL HAS EXPIRED
6. REQUESTED EXPIRATION DATE
YES
X
f. EXISTING COLLECTION IN USE WITHOUT AN OMB CONTROL
NUMBER
X
NO
a. THREE YEARS FROM APPROVAL DATE
b. OTHER:
7. TITLE
Technical Assistance and Training and Training for Innovative Regional Wastewater Treatment Solutions (TAT/RWTS) Pilot Grant
Programs.
8. AGENCY FORM NUMBER(S) (if applicable)
SF 424, SF 270, SF 424A, SF 425
9. KEYWORDS
10. ABSTRACT
This collection is associated with the Notice of Funds Availability (NOFA). The collection of information from the public is
necessary for the Rural Utilities Service (RUS) to identify projects eligible for the TAT/RWTS Pilot Program grants.
12. OBLIGATION TO RESPOND (X one)
11. AFFECTED PUBLIC (Mark primary with "P" and all others that apply with "X")
X
a. VOLUNTARY
a. INDIVIDUALS OR HOUSEHOLDS
d. FARMS
b. BUSINESS OR OTHER FOR-PROFIT
e. FEDERAL GOVERNMENT
c. NOT-FOR-PROFIT INSTITUTIONS
f. STATE, LOCAL OR TRIBAL GOVERNMENT
13. ANNUAL REPORTING AND RECORDKEEPING HOUR BURDEN
a. NUMBER OF RESPONDENTS
b. TOTAL ANNUAL RESPONSES
(1) Percentage of these responses collected electronically
c. TOTAL ANNUAL HOURS REQUESTED
d. CURRENT OMB INVENTORY
9
149
100.00
647
242
e. DIFFERENCE (+, -)
f.
EXPLANATION OF
DIFFERENCE:
X
a. TOTAL CAPITAL/STARTUP COSTS
15. PURPOSE OF INFORMATION COLLECTION (Mark primary with
c. TOTAL ANNUALIZED COST REQUESTED
d. CURRENT OMB INVENTORY
e. DIFFERENCE (+, -)
a. APPLICATION FOR BENEFITS
c. GENERAL PURPOSE STATISTICS
d. AUDIT
17. STATISTICAL METHODS
Does this information collection employ
statistical methods?
YES
OMB FORM 83-I, 10/95
X
NO
0.00
0.00
(2) Adustment (+, -)
16. FREQUENCY OF RECORDKEEPING OR REPORTING (X all that apply)
a. RECORDKEEPING
e. PROGRAM PLANNING
OR MANAGEMENT
b. PROGRAM EVALUATION
EXPLANATION OF DIFFERENCE:
(1) Program change (+, -)
"P" and all others that apply with "X")
X
0.00
0.00
0.00
0
0
b. TOTAL ANNUAL COSTS (O&M)
+405
+405
(2) Adustment (+, -)
c. MANDATORY
14. ANNUALIZED COST TO RESPONDENTS (In thousands of dollars)
f.
(1) Program change (+, -)
b. REQUIRED TO OBTAIN OR RETAIN BENEFITS
X
f. RESEARCH
g. REGULATORY OR
COMPLIANCE
b. THIRD PARTY DISCLOSURE
c. REPORTING:
X
(1) On Occasion
(2) Weekly
(4) Quarterly
(5) Semi-Annually
(7) Biennially
(8) Other (Describe)
(3) Monthly
X
(6) Annually
18. AGENCY CONTACT (Person who can best answer questions regarding the content of this
submission)
a. NAME (Last, First, Middle Initial)
Arlette Mussington
b. TELEPHONE NUMBER (Include
area code)
(202) 720-2825
OMB CONTROL NUMBER
0572
0157
TITLE
Technical Assistance and Training and Training for Innovative Regional Wastewater Treatment
Solutions (TAT/RWTS) Pilot Grant Programs.
19. CERTIFICATION FOR PAPERWORK REDUCTION ACT SUBMISSIONS
a. PROGRAM OFFICIAL CERTIFICATION
(1) Signature
(2) Date
1/21/2021
Arlette Mussington
On behalf of this Federal agency, I certify that the collection of information encompassed by this request
complies with 5 CFR 1320.9.
NOTE: The text of 5 CFR 1320.9, and the related provisions of 5 CFR 1320.8(b)(3), appear at the end of the
instructions. The certification is to be made with reference to those regulatory provisions as set forth in the
instructions.
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 (see note in Item 19 of the instructions);
(i) If applicable, it uses effective and efficient statistical survey methodology; and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item below and explain the
reason in Item 18 of the Supporting Statement.
b. SENIOR OFFICIAL OR DESIGNEE CERTIFICATION
(1) Signature
OMB FORM 83-I (BACK), 10/95
(2) Date
File Type | application/pdf |
File Title | Office of Management and Budget Form 83-I. PAPERWORK REDUCTION ACT SUBMISSION . |
File Modified | 2021-01-21 |
File Created | 2000-05-31 |