Private

The following non-form items and three RD forms approved under other packages comprise the burden numbers for 0575-0180:

Data Universal Number System (DUNS) and System for Award Management System (SAM)

All grant applicants must obtain a Dun and Bradstreet Data Universal Numbering System (DUNS) number and register in the System for Award Management (SAM) prior to submitting a grant application pursuant to 2 CFR 25.200(b). A DUNS number is a unique nine-character number used to identify your organization. It can be obtained by visiting the DUNS & Bradstreet website or by calling the toll-free number. The estimated number of respondents is 75 and the average response time is estimated to be 15 minutes.

Certification of Non-Lobbying Activities

A written statement (normally on company letterhead) is required to certify whether or not lobbying activities have occurred. This document certifies that the applicant has not been involved in lobbying activities in connection with any Federal contracts, grants and loans.

It also requires the applicant to complete and submit Standard Form LLL, "Disclosure of Lobbying Activities" if such activity has taken place. The estimated number of respondents is 75 and the average response time is estimated to be 15 minutes.

Application

The written portion of the application consists of the following components.

1. A summary page listing the applicant's name, address, telephone number, contact person’s email and telephone number, county and congressional district where applicant is located, amount of grant request and number of recipients.

2. A detailed Table of Contents containing page numbers for each component of the application.

2. A project overview, no longer than one page, which should include:

1. The type of financial and technical assistance to be provided and how it will be implemented.

2. How the capacity and ability of the recipients will be improved.

3. The overall goal to be accomplished.

4. The benchmarks to be used to measure the success of the program.

2. Organizational documents, such as a certificate of incorporation and a current good standing certification from the Secretary of State where the applicant is incorporated and other similar and valid documentation of current non-profit status, from the intermediary that confirms it has been legally organized for a minimum of 3 years as the applicant entity.

2. Verification of matching funds, i.e., a copy of a bank statement if matching funds are in cash or a copy of the confirmed funding commitment from the funding source.

2. The following information for each recipient:

1. Recipient’s entity name,

2. Complete address (mailing and physical location, if different),

3. County where located,

4. Number of congressional district where recipient is located,

5. Contact person’s name, email address and telephone number, and

2. Submit evidence the recipient entity is eligible.

1. Nonprofits – provide a current valid letter confirming non-profit status or a current good standing certification from the Secretary of State or other valid documentation of current nonprofit status.

2. Low-income community – provide evidence the entity is a public body (copy of Charter, relevant Acts of Assembly, relevant court orders (if created judicially) or other valid documentation), a copy of the 2010 census data to verify the population, and 2010 American Community Survey data as evidence that the median household income is at, or below, 80 percent of either the State or national median household income.

3. Federally recognized tribes – provide the page listing their name from the Federal Register list of tribal entities published most recently by the Bureau of Indian Affairs. The 2020 list is available at 85 FR 5462 pages 5462-5467 and https://www.govinfo.gov/content/pkg/FR-2020-01-30/pdf/2020-01707.pdf.

2. Address each of the “Evaluation Criteria” in narrative form. Narrative is limited to five pages per criterion. The “Evaluation Criteria” are Building Capacity and Expertise, Soundness of Approach and Population and Income. Specialty Criteria Points include State Director and Administrator Discretionary Points.

2. A timeline identifying specific activities and proposed dates for completion.

2. A detailed project budget that includes the RCDI grant amount and matching funds for the duration of the grant.

The estimated number of respondents is 75 and the average response time is estimated to be 10 hours. This also includes the time it takes to sign the grant agreement.

Association or Relationship with Rural Development Employee

A written statement acknowledging whether or not a relationship exists is required. The applicant has to identify any known relationship or association with a Rural Development employee, members of their families, known close relatives, or business associates. The estimated number of respondents is 75 and the average response time is estimated to be 15 minutes.

Grantees/Awardees – Reporting Requirements – Non-forms

Modification of Application for Reduced Grant Amount

If an applicant is awarded a grant that is less than the amount requested, they are required to modify their application to conform to the reduced amount. Any modifications must be within the scope of the original application. Based on previous history, the agency estimated the average number of respondents will be 20 and the average response time is estimated to be 60 minutes.

Performance Progress Report

Grantees will be required to submit a performance progress report on a quarterly basis. The report will describe the activities that were funded during that quarter, who received funding, how much funding was used, and other pertinent information as described in the grant agreement. The report can vary in length depending on the size of the project. The estimated number of respondents is 90 and the average response time is estimated to be 60 minutes.

Final Performance Progress Report

A final report may serve as the last quarterly report. This will be the last performance progress report and must address the following items in addition to the previously stated requirements for the performance project report. These items are: (a) identify the most challenging or unexpected aspects of the program; (b) the strengths and limitations of the program and any advice that would be helpful to other organizations; and (c) identify any post-grant plans for the project and how they will be financed (d) will the program continue after closing of the grant; and (e) were the recipient(s)’ goals accomplished (f) what mission area were the funds used(g) and other pertinent information as described in the grant agreement. The length of the report will vary depending on the size of the project. The estimated number of respondents is 90 and the average response time is estimated to be 120 minutes.

Financial Reporting

A financial report will be submitted on a not more than monthly basis to indicate how grant and matching funds were used. The report should include submittal of back-up documentation sufficient to show who received funds, what was the amount of funds used, and for what purpose. The estimated number of respondents is 90 and the average response time is estimated to be 60 minutes.

Financial Management System

The system must enable the grantee to track fund usage as to who received funds, the amount of funds they received, retain financial records, and supporting documents. With respect to a financial management system, it is believed grantees would already have and maintain a recordkeeping system under normal business practices. The estimated number of respondents is 90 and the average response time is estimated to be 6 hours.

Audits

A Grantee that expends $750,000 or more during the Grantee’s fiscal year in Federal awards must have a single or program-specific audit conducted for that year in accordance with 2 CFR 200.514. If Grantee expends less than $750,000 in Federal awards during its fiscal year, records must be available for review or audit by the Agency and General Accountability Office (GAO). The estimated number of respondents is 20 and the average response time is estimated to be 3 hours. This response time includes the time for an accountant to produce an audit.

Record Keeping Requirements

Data Collection by Race, Sex, and National Origin

The grantee must collect and maintain data on recipients by race, sex, and national origin. The grantee must ensure that their recipients also collect and maintain data on beneficiaries (entities or individuals that receive benefits from assistance provided by the recipient) by race, sex, and national origin. This data is required by Title VI of the Civil Rights Act of 1964 and must be provided to RHS for compliance review purposes. The estimated number of respondents for the Intermediaries is 30. The estimated number of respondents for the recipients and beneficiaries is 870 for a total of 900, and the average response time is estimated to be 60 minutes.

Reporting Requirements – Forms

Form RD 400-4, "Assurance Agreement"

All recipients are required to complete this form to comply with Civil Rights Acts and laws. The estimated number of respondents is 90 and the average response time is estimated to be 15 minutes.

Form RD 442-2, "Statement of Budget, Income, and Equity"

This form serves as a budget and an income and expense statement. If Federal funds expended during a one-year period are less than $750,000 and there is an outstanding loan balance of less than $750,000 the grantee is required to submit a management report. This form is part of the management report. The estimated number of respondents is 90 and the average response time is estimated to be 1.5 hours.

Form RD 442-3, "Balance Sheet"

This form is used by grantees present their assets, liabilities, and net worth. If Federal funds expended during a one-year period are less than $750,000 and there is an outstanding loan balance of less than $750,000 the grantee is required to submit a management report. This form is part of the management report. The estimated number of respondents is 90 and the average response time is estimated to be 60 minutes