Rural Community Development Initiative (RCDI)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form AD 3030 Representations Regarding Felony Conviction and Tax Delinquent Status for Coporate Applicants	Form	Removed	Available
Form RD 442-3 Balance Sheet	Form	Removed	Available
Form RD 442-2 Statement of Budget, Income and Equity	Form	Removed	Available
Form RD 400-4 Assurance Agreement	Form	Removed	Available
Form RD 400-1 Equal Opportunity Agreement	Form	Removed	Available
Form AD-1049 Certification for Drug-Free Workplace	Form	Removed	Available
Form AD-1048 Certification Regarding Debarrment, etc. - Lower Tier	Form	Removed	Available
Form AD-1047 Certification Regarding Debarrment, etc.	Form	Removed	Available
Form AD-1047 Public/Tribal	Form	Removed	Repair queued
RCDI Supporting Statement-final updated 1-28-22.docx	Supporting Statement A	Uploaded 2022-01-28	Available
RCDI Supporting Statement-final.docx	Supporting Statement A	Uploaded 2021-03-15	Missing upstream
ICR 0575-0180 Summary Worksheet final.xlsm	Supplementary Document	Uploaded 2021-02-17	Available
ICR 0575-0180 Summary Worksheet final.xlsm	Supplementary Document	Uploaded 2021-02-17	Missing upstream

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
2036	Private	Other-	Modified
181552	Public/Tribal	Form	Removed	Representations Regarding Felony Conviction and Tax Delinquent Status for Coporate Applicants
181552	Public/Tribal	Form	Removed	Balance Sheet
181552	Public/Tribal	Form	Removed	Statement of Budget, Income and Equity
181552	Public/Tribal	Form	Removed	Assurance Agreement
181552	Public/Tribal	Form	Removed	Equal Opportunity Agreement
181552	Public/Tribal	Form	Removed	Certification for Drug-Free Workplace
181552	Public/Tribal	Form	Removed	Certification Regarding Debarrment, etc. - Lower Tier
181552	Public/Tribal	Form	Removed	Certification Regarding Debarrment, etc.
181552	Public/Tribal	Form	Removed

ICR Details

OMB Control No: 0575-0180	ICR Reference No: 202102-0575-004
Status: Active	Previous ICR Reference No: 201804-0575-001
Agency/Subagency: USDA/RHS	Agency Tracking No:
Title: Rural Community Development Initiative (RCDI)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 01/28/2022
Retrieve Notice of Action (NOA)	Date Received in OIRA: 07/20/2021
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2025	36 Months From Approved	01/31/2022
Responses	3,130	0	3,640
Time Burden (Hours)	4,194	0	4,549
Cost Burden (Dollars)	0	0	0

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Abstract: The Rural Community Development Initiative's intent is to develop the capacity and ability of rural area recipients through a program of technical assistance provided by qualified intermediary organizations.

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Authorizing Statute(s): PL: Pub.L. 106 - 78 306 Name of Law: Agriculture, Rural Development, FDA 7 Related Agencies Appropriations Act 2000
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 243	12/17/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 37731	07/16/2021
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Private
Public/Tribal	RD 400-1, RD 400-4, RD 442-2, RD 442-3, AD-1048 , AD-1047, AD-1049, AD 3030	Certification Regarding Debarrment, etc. ,   Certification Regarding Debarrment, etc. - Lower Tier ,   Certification for Drug-Free Workplace ,   Equal Opportunity Agreement ,   Assurance Agreement ,   Statement of Budget, Income and Equity ,   Balance Sheet ,   Representations Regarding Felony Conviction and Tax Delinquent Status for Coporate Applicants

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	3,130	3,640	0	0	-510	0
Annual Time Burden (Hours)	4,194	4,549	0	0	-355	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: With this renewal, annual responses decreased by 510 to 3,130 and hours decreased by 355 for a total of 4,194 in burden. The adjustment decrease in both the number of responses and hours is based on a decrease in the number of respondents. In addition, several required forms are no longer required. The Certifications and Representations have historically been collected via forms such as AD 1047, AD 1048 and AD1049. To decrease burden and costs of separate requests for information, the collection of this information has been incorporated within SAM.gov registration, Financial Assistance General Certifications and Representations.

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Annual Cost to Federal Government: $306,964

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

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.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 07/20/2021

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