Federal and Non-Federal Financial Assistance Instruments

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form FS-1500-34 Grant Equipment Justification and Certification Statement	Form	Unchanged	Repair queued
Form FS-1500-22B Financial Capability Checklist for State Agencies and Individuals	Form	Unchanged	Repair queued
Form FS-1500-22A Financial Capability Checklist	Form	Unchanged	Repair queued
Form FS-1500-22 Financial Capability Questionnaire	Form	Unchanged	Repair queued
Form FS-1500-13b Nondisclosure Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-13a Material Transfer Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-12 Cost-Reimbursable Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-15a Memorandum of Understanding for Cooperative Frequency Use	Form and Instruction	Unchanged	Repair queued
Form FS-1500-15 Memorandum of Understanding	Form and Instruction	Unchanged	Repair queued
Form FS-1500-16b Participating Agreement Supplemental Project Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-16a Master Participating Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-18 Collection Agreement Financial Plan	Form and Instruction	Unchanged	Repair queued
Form FS-1500-17c Agreements Financial Plan (Medium Form)	Form and Instruction	Unchanged	Repair queued
Form FS-1500-17b Agreements Financial Plan (Short)	Form and Instruction	Unchanged	Repair queued
Form FS-1500-21d Stewardship Agreement (Short Form)	Form and Instruction	Unchanged	Repair queued
Form FS-1500-21c Stewardship Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-21b Stewardship Agreement Financial Plan	Form and Instruction	Unchanged	Repair queued
Form FS-1500-21a Stewardship Agreement SPA	Form and Instruction	Unchanged	Repair queued
Form FS-1500-21 Master Stewardship Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-16g Non Funded Participating Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-16f Participating Agreement for Fuels or Noxious Weed Treatment	Form and Instruction	Unchanged	Repair queued
Form FS-1500-16 Participating Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-14a International Joint Venture	Form and Instruction	Unchanged	Repair queued
Form FS-1500-14 Joint Venture Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-13 Cooperative Research and Development Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-11 Collection Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-10c Non Funded Challenge Cost Share Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-9a Road Project Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-9 Cooperative Forest Road Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-10 Challenge Cost Share Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-35 Certification Regarding Lobbying	Form	Unchanged	Repair queued
Form FS-1500-19 Modification of Grant or Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-23 Optional Project Progress Report	Form and Instruction	Unchanged	Repair queued
Form SF-424 (R&R) Application for Federal Assistance (Research & Related)	Form and Instruction	Unchanged	Repair queued
Form SF-424 (Individual Application for Federal Assistance (Individual)	Form and Instruction	Unchanged	Repair queued
Form FS-1500-17a Financial Plan Long Form	Form and Instruction	Unchanged	Repair queued
Form FS-1500-17a Individuals	Form and Instruction	Unchanged	Repair queued
Form FS-1500-22A Financial Capability Checklist	Form	Unchanged	Repair queued
Form FS-1500-22 Financial Capability Questionnaire	Form	Unchanged	Repair queued
Form FS-6500-235 De-obligation and Closeout Request Form	Form and Instruction	Unchanged	Repair queued
Form FS-1500-37 Good Neighbor Agreement Appropriations Act Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-36b Good Neighbor Agreement Supplemental Project Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-36a Good Neighbor Agreement Master Farm Bill Agreement	Form and Instruction	Unchanged	Repair queued
Form FA-1500-36 Good Neighbor Agreement	Form and Instruction	Unchanged	Repair queued
Form Supplemental Provi Supplemental Provisions to the 7600A	Form and Instruction	Unchanged	Repair queued
Form FS-1500-21d Stewardship Agreements (Short Form)	Form and Instruction	Unchanged	Repair queued
Form FS-1500-16g Non Funded Participating Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-10c Non Funded Challenge Cost Share Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-35 Certification Regarding Lobbying	Form	Unchanged	Repair queued
Form FS-1500-34 Grant Equipment Justification and Certification Statement	Form	Unchanged	Repair queued
Form FS-1500-22b Financial Capability Checklist for State Government Agencies Only	Form	Unchanged	Repair queued
Form FS-1500-22 Financial Capability Questionaire	Form and Instruction	Unchanged	Repair queued
Form FS-1500-23 Optional Project Progress Report	Form and Instruction	Unchanged	Repair queued
Form SF-424 (R&R) Application for Federal Assistance (Research & Related)	Form and Instruction	Unchanged	Repair queued
Form SF-424 Application for Federal Assistance	Form and Instruction	Unchanged	Repair queued
Form FS-1500-16f Participating Agreement for Fuels or Noxious Weed Treatment	Form and Instruction	Unchanged	Repair queued
Form FS-1500-16e Participating Agreement SPA with Interpretive Association	Form and Instruction	Unchanged	Repair queued
Form FS-1500-16d Master Participating Agreement with Interpretive Association	Form and Instruction	Unchanged	Repair queued
Form FS-1500-16c Participating Agreement with Interpretive Association	Form and Instruction	Unchanged	Repair queued
Form FS-1500-14A International Joint Venture Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-11B Collection Agrement RMEF Advance	Form and Instruction	Unchanged	Repair queued
Form FS-1500-11A Collection Agreement RMEF Reimbursable	Form and Instruction	Unchanged	Repair queued
Form FS-1500-21c Stewardship Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-21b Stewardship Financial Plan	Form and Instruction	Unchanged	Repair queued
Form FS-1500-21a Stewardship Agreement Supplemental Project Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-21 Master Stewardship Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-17c Agreement Financial Plan (Medium Form)	Form and Instruction	Unchanged	Available
Form FS-1500-16b Participating Agreement Supplemental Project Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-16a Master Participating Agrement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-10b Challenge Cost Share Supplemental Project Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-15a Memorandum of Understanding for Cooperative Frequency Usage	Form and Instruction	Unchanged	Repair queued
Form FS-1500-13b Nondisclosure Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-13a Material Transfer Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-10a Master Challenge Cost Share Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-9a Road Project Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-18 Collection Agreement Financial Plan	Form and Instruction	Unchanged	Repair queued
Form FS-1500-17b Financial Plan B	Form and Instruction	Unchanged	Available
Form FS-1500-17a Financial Plan A	Form and Instruction	Unchanged	Repair queued
Form FS-1500-15 Memorandum of Understanding	Form and Instruction	Unchanged	Repair queued
Form FS-1500-9 Cooperative Forest Road Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-8a Cooperative Law Enforcement AOP	Form and Instruction	Unchanged	Repair queued
Form FS-1500-7 Cooperative Fire Protection Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-19 Modification Form	Form and Instruction	Unchanged	Repair queued
Form FS-1500-8 Coooperative Law Enforcement Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-16 Participating Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-14 Joint Venture Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-13 Cooperative Research and Development Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-12 Cost-Reimbursable Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-11 Collection Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-10 Challenge Cost-Share Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-10 State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Available
Form FS-1500-22B Financial Capability Checklist for State Government Agencies	Form	Unchanged	Repair queued
Form FS-1500-23 Optional Project Progress Report	Form	Unchanged	Repair queued
Form FS-1500-21d Stewardship Agreement (Short Form)	Form and Instruction	Unchanged	Repair queued
Form FS-1500-16g Non Funded Participating Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-11b Advance Collection Agreement, Rocky Mountain Elk Foundation	Form and Instruction	Unchanged	Repair queued
Form FS-1500-11a Reimbursable Collection Agreement with Rocky Mountian Elk Foundation	Form and Instruction	Unchanged	Repair queued
Form FS-1500-10c Non-Funded Challenge Cost Share Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-35 Certification Regarding Lobbying	Form	Unchanged	Repair queued
Form FS-1500-34 Grant Equipment Justification and Certification Statement	Form	Unchanged	Repair queued
Form FS-1500-22a Financial Capability Checklist	Form	Unchanged	Repair queued
Form FS-1500-22 Financial Capability Questionaire	Form and Instruction	Unchanged	Repair queued
Form FS-1500-23 Optional Project Progress Report	Form and Instruction	Unchanged	Repair queued
Form SF-424 (R&R) Application for Federal Assistance – Research	Form and Instruction	Unchanged	Repair queued
Form SF-424 Application for Federal Assistance	Form and Instruction	Unchanged	Repair queued
Form FS-1500-21c Stewardship Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-21b Stewardship Financial Plan	Form and Instruction	Unchanged	Repair queued
Form FS-1500-21a Stewardship Agreement Supplemental Project Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-21 Master Stewardship Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-16f Participating Agreement for Fuels or Noxious Weed Treatment	Form and Instruction	Unchanged	Repair queued
Form FS-1500-16e Participating Agreement Supplemental Project Agreement with Interpretive Associations	Form and Instruction	Unchanged	Repair queued
Form FS-1500-16d Master Participating Agreement with Interpretative Associations	Form and Instruction	Unchanged	Repair queued
Form FS-1500-15a Memorandum of Understanding for Cooperative Frequency Usage	Form and Instruction	Unchanged	Repair queued
Form FS-1500-17c FS 1500-17c Financial Plan Medium Form	Form and Instruction	Unchanged	Repair queued
Form FS-1500-16c FS 1500-16c Participating Agreement with Interpretive Association	Form and Instruction	Unchanged	Repair queued
Form FS-1500-16b FS 1500-16b Participating Agreement SPA	Form and Instruction	Unchanged	Repair queued
Form FS-1500-16a FS 1500-16a Master Participating Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-14a FS 1500-14a International Joint Venture Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-13b FS 1500-13b Nondisclosure Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-13a FS 1500-13a Material Transfer Agreement.doc	Form and Instruction	Unchanged	Repair queued
Form FS-1500-10b FS 1500-10b Challenge Cost Share SPA	Form and Instruction	Unchanged	Repair queued
Form FS-1500-10a FS 1500-10a Master Challenge Cost Share Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-9a FS 1500-9a Road Project Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-8a FS 1500-8a Cooperative Law Enforcement AOP.doc	Form and Instruction	Unchanged	Repair queued
Form FS-1500-8 FS 1500-8 Cooperative Law Enforcement Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-7 FS 1500-7 Cooperative Fire Agreement.doc	Form and Instruction	Unchanged	Repair queued
Form FS-1500-18 Collection Agreement Financial Plan	Form and Instruction	Unchanged	Repair queued
Form FS-1500-17b Financial Plan (form B)	Form and Instruction	Unchanged	Repair queued
Form FS-1500-17a Financial Plan (form A)	Form and Instruction	Unchanged	Repair queued
Form FS-1500-15 Memorandum of Understanding	Form and Instruction	Unchanged	Repair queued
Form FS-1500-9 Cooperative Forest Road Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-19 Modification Form	Form and Instruction	Unchanged	Repair queued
Form FS-1500-16 Participating Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-14 Joint Venture Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-13 Cooperative Research and Development Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-12 Cost-Reimbursable Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-11 Collection Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-10 Challenge Cost-Share Agreement	Form and Instruction	Unchanged	Repair queued
Form FS-1500-10 Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Repair queued
Supplemental Provisions to the 7600A.docx	Supplementary Document	Uploaded 2021-03-31	Repair queued
Supplemental Provisions to the 7600A.docx	Supplementary Document	Uploaded 2021-03-31	Repair queued
Supplemental Provisions to the 7600A.docx	Supplementary Document	Uploaded 2021-03-31	Repair queued
SPF-CF handbook.pdf	Supplementary Document	Uploaded 2021-03-31	Repair queued
Partnership-Guide_2005.pdf	Supplementary Document	Uploaded 2021-03-31	Available
Partner With Us September 2012 FINAL.pdf	Supplementary Document	Uploaded 2021-03-31	Repair queued
Forest Legacy Attachment C.docx	Supplementary Document	Uploaded 2021-03-31	Available
Domestic Grant 2.0.docx	Supplementary Document	Uploaded 2021-03-31	Repair queued
203-partnership-authorities-instruments.ppt	Supplementary Document	Uploaded 2021-03-31	Repair queued
International Cooperative Agreement.docx	Supplementary Document	Uploaded 2021-03-31	Repair queued
Cooperative Agreement 2.0.docx	Supplementary Document	Uploaded 2021-03-31	Repair queued
0596-0217-Supporting Statement -- Final.daj.docx	Supporting Statement A	Uploaded 2021-04-29	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
208925	Individuals	Form	Unchanged	Grant Equipment Justification and Certification Statement
208925	Individuals	Form	Unchanged	Financial Capability Checklist for State Agencies and Individuals
208925	Individuals	Form	Unchanged	Financial Capability Checklist
208925	Individuals	Form	Unchanged	Financial Capability Questionnaire
208925	Individuals	Form and Instruction	Unchanged	Nondisclosure Agreement
208925	Individuals	Form and Instruction	Unchanged	Material Transfer Agreement
208925	Individuals	Form and Instruction	Unchanged	Cost-Reimbursable Agreement
208925	Individuals	Form and Instruction	Unchanged	Memorandum of Understanding for Cooperative Frequency Use
208925	Individuals	Form and Instruction	Unchanged	Memorandum of Understanding
208925	Individuals	Form and Instruction	Unchanged	Participating Agreement Supplemental Project Agreement
208925	Individuals	Form and Instruction	Unchanged	Master Participating Agreement
208925	Individuals	Form and Instruction	Unchanged	Collection Agreement Financial Plan
208925	Individuals	Form and Instruction	Unchanged	Agreements Financial Plan (Medium Form)
208925	Individuals	Form and Instruction	Unchanged	Agreements Financial Plan (Short)
208925	Individuals	Form and Instruction	Unchanged	Stewardship Agreement (Short Form)
208925	Individuals	Form and Instruction	Unchanged	Stewardship Agreement
208925	Individuals	Form and Instruction	Unchanged	Stewardship Agreement Financial Plan
208925	Individuals	Form and Instruction	Unchanged	Stewardship Agreement SPA
208925	Individuals	Form and Instruction	Unchanged	Master Stewardship Agreement
208925	Individuals	Form and Instruction	Unchanged	Non Funded Participating Agreement
208925	Individuals	Form and Instruction	Unchanged	Participating Agreement for Fuels or Noxious Weed Treatment
208925	Individuals	Form and Instruction	Unchanged	Participating Agreement
208925	Individuals	Form and Instruction	Unchanged	International Joint Venture
208925	Individuals	Form and Instruction	Unchanged	Joint Venture Agreement
208925	Individuals	Form and Instruction	Unchanged	Cooperative Research and Development Agreement
208925	Individuals	Form and Instruction	Unchanged	Collection Agreement
208925	Individuals	Form and Instruction	Unchanged	Non Funded Challenge Cost Share Agreement
208925	Individuals	Form and Instruction	Unchanged	Road Project Agreement
208925	Individuals	Form and Instruction	Unchanged	Cooperative Forest Road Agreement
208925	Individuals	Form and Instruction	Unchanged	Challenge Cost Share Agreement
208925	Individuals	Form	Unchanged	Certification Regarding Lobbying
208925	Individuals	Form and Instruction	Unchanged	Modification of Grant or Agreement
208925	Individuals	Form and Instruction	Unchanged	Optional Project Progress Report
208925	Individuals	Form and Instruction	Unchanged	Application for Federal Assistance (Research & Related)
208925	Individuals	Form and Instruction	Unchanged	Application for Federal Assistance (Individual)
208925	Individuals	Form and Instruction	Unchanged	Financial Plan Long Form
208925	Individuals	Form and Instruction	Unchanged
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form	Unchanged	Financial Capability Checklist
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form	Unchanged	Financial Capability Questionnaire
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	De-obligation and Closeout Request Form
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Good Neighbor Agreement Appropriations Act Agreement
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Good Neighbor Agreement Supplemental Project Agreement
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Good Neighbor Agreement Master Farm Bill Agreement
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Good Neighbor Agreement
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Supplemental Provisions to the 7600A
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Stewardship Agreements (Short Form)
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Non Funded Participating Agreement
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Non Funded Challenge Cost Share Agreement
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form	Unchanged	Certification Regarding Lobbying
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form	Unchanged	Grant Equipment Justification and Certification Statement
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form	Unchanged	Financial Capability Checklist for State Government Agencies Only
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Financial Capability Questionaire
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Optional Project Progress Report
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Application for Federal Assistance (Research & Related)
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Application for Federal Assistance
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Participating Agreement for Fuels or Noxious Weed Treatment
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Participating Agreement SPA with Interpretive Association
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Master Participating Agreement with Interpretive Association
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Participating Agreement with Interpretive Association
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	International Joint Venture Agreement
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Collection Agrement RMEF Advance
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Collection Agreement RMEF Reimbursable
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Stewardship Agreement
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Stewardship Financial Plan
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Stewardship Agreement Supplemental Project Agreement
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Master Stewardship Agreement
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Agreement Financial Plan (Medium Form)
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Participating Agreement Supplemental Project Agreement
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Master Participating Agrement
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Challenge Cost Share Supplemental Project Agreement
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Memorandum of Understanding for Cooperative Frequency Usage
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Nondisclosure Agreement
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Material Transfer Agreement
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Master Challenge Cost Share Agreement
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Road Project Agreement
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Collection Agreement Financial Plan
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Financial Plan B
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Financial Plan A
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Memorandum of Understanding
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Cooperative Forest Road Agreement
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Cooperative Law Enforcement AOP
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Cooperative Fire Protection Agreement
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Modification Form
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Coooperative Law Enforcement Agreement
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Participating Agreement
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Joint Venture Agreement
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Cooperative Research and Development Agreement
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Cost-Reimbursable Agreement
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Collection Agreement
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Challenge Cost-Share Agreement
185951	State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form	Unchanged	Financial Capability Checklist for State Government Agencies
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form	Unchanged	Optional Project Progress Report
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Stewardship Agreement (Short Form)
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Non Funded Participating Agreement
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Advance Collection Agreement, Rocky Mountain Elk Foundation
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Reimbursable Collection Agreement with Rocky Mountian Elk Foundation
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Non-Funded Challenge Cost Share Agreement
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form	Unchanged	Certification Regarding Lobbying
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form	Unchanged	Grant Equipment Justification and Certification Statement
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form	Unchanged	Financial Capability Checklist
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Financial Capability Questionaire
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Optional Project Progress Report
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Application for Federal Assistance – Research
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Application for Federal Assistance
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Stewardship Agreement
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Stewardship Financial Plan
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Stewardship Agreement Supplemental Project Agreement
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Master Stewardship Agreement
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Participating Agreement for Fuels or Noxious Weed Treatment
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Participating Agreement Supplemental Project Agreement with Interpretive Associations
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Master Participating Agreement with Interpretative Associations
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Memorandum of Understanding for Cooperative Frequency Usage
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	FS 1500-17c Financial Plan Medium Form
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	FS 1500-16c Participating Agreement with Interpretive Association
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	FS 1500-16b Participating Agreement SPA
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	FS 1500-16a Master Participating Agreement
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	FS 1500-14a International Joint Venture Agreement
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	FS 1500-13b Nondisclosure Agreement
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	FS 1500-13a Material Transfer Agreement.doc
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	FS 1500-10b Challenge Cost Share SPA
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	FS 1500-10a Master Challenge Cost Share Agreement
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	FS 1500-9a Road Project Agreement
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	FS 1500-8a Cooperative Law Enforcement AOP.doc
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	FS 1500-8 Cooperative Law Enforcement Agreement
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	FS 1500-7 Cooperative Fire Agreement.doc
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Collection Agreement Financial Plan
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Financial Plan (form B)
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Financial Plan (form A)
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Memorandum of Understanding
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Cooperative Forest Road Agreement
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Modification Form
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Participating Agreement
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Joint Venture Agreement
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Cooperative Research and Development Agreement
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Cost-Reimbursable Agreement
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Collection Agreement
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged	Challenge Cost-Share Agreement
185950	Private Sector - Federal/Non-Federal Financial Assistance Instruments	Form and Instruction	Unchanged

ICR Details

OMB Control No: 0596-0217	ICR Reference No: 202103-0596-002
Status: Historical Active	Previous ICR Reference No: 201710-0596-002
Agency/Subagency: USDA/FS	Agency Tracking No:
Title: Federal and Non-Federal Financial Assistance Instruments
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/11/2022
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/21/2021
Terms of Clearance: Approval is granted for one year due to lack of response to OMB comments from the agency during review for 2 months. The agency is reminded to provide prompt response during review. The USFS is reminded to provide a breakdown of the burden for each activity and a description of how the burden and costs were estimated. The USFS is reminded to state whether the collection is voluntary or mandatory and cite the authority to collect (5 CFR 1320.8(b)(3)(iv)) on all forms.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2023	36 Months From Approved	02/28/2022
Responses	4,890	0	4,890
Time Burden (Hours)	42,445	0	42,445
Cost Burden (Dollars)	0	0	0

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Abstract: The purpose of this collection is to collect information necessary for Forest Service to conduct the Agency's Federal and Non-Federal Financial Assistance program to develop projects, make or receive payment, monitor projects, as well as the necessary statements of work and financial plans.

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Authorizing Statute(s): US Code: 16 USC 532-538 Name of Law: National Forest Roads and Trails Act of 10/13/1965 (Pub. L. 88-657)
   US Code: 16 USC 1246(h) Name of Law: National Trails System Act (Pub. L. 90-543)
   US Code: 16 USC 1271 et seq. Name of Law: Wild and Scenic Rivers Act (Pub. L. 90-542)
   US Code: 7 USC 2814 Name of Law: Federal Noxious Weed Act of 1974 (Pub. L. 93-629, Pub. L. 101-624)
   US Code: 42 USC 12501 Name of Law: National and Community Service Act of 1990 (Pub. L. 101-610)
   US Code: 7 USC 2269 Name of Law: Acceptance of Gifts Act of October 10, 1978
   US Code: 7 USC 3318-3319 Name of Law: Food Security Act of 1985
   US Code: 16 USC 670g-670l, 670o Name of Law: Sikes Act of September 1, 1960
   PL: Pub.L. 111 - 11 30001 Name of Law: Wyden Amendment
   PL: Pub.L. 106 - 393 All Name of Law: Secure Rural Schools and Community Self-Determination Act of 2000
   PL: Pub.L. 108 - 7 323 Name of Law: Stewardship Authority
   US Code: 31 USC 6301-6308 Name of Law: Federal Grants and Cooperative Agreements Act of 1977, as amended (Pub. L. 97-258, as amended)
   US Code: 16 USC 565al-a3 Name of Law: Cooperative Funds and Deposits Act of 12/12/1975, Pub. L. 95-442
   PL: Pub.L. 102 - 154 Challenge Cost Share Name of Law: Interior and Related Agencies Appropriations Act of 1992
   US Code: 5 USC 3343, 3581-3584 Name of Law: Federal Employees International Organization Service Act, as amended
   US Code: 16 USC 551a Name of Law: Cooperative Law Enforcement Act of August 10, 1971 (Pub. L. 92-82)
   US Code: 15 USC 3710a Name of Law: Federal Technology Transfer Act of 1986, Pub. L 96-480
   US Code: 16 USC 1701-1706 Name of Law: Youth Conservation Corps Act of 1970, as amended
   US Code: 16 USC 1641-1646 Name of Law: Forest and Rangeland Renewable Resources Research Act of 1978, as amended (Pub. L 95-307)
   US Code: 16 USC 2101-2114 Name of Law: Cooperative Forestry Assistance Act of 1978, as amended (Pub. L. 95-313)
   US Code: 7 USC 6601 Name of Law: National Forest Dependent Rural Communities Economic Diversification Act of 1990
   US Code: 42 USC 1856a Name of Law: Reciprocal Fire Act of May 27, 1955 (Pub. L. 84-46)
   US Code: 16 USC 498 Name of Law: Cooperative Funds Act of 6/30/1914, as amended by Pub. L. 104-127
   US Code: 16 USC 572 Name of Law: Granger-Thye Act of 4/24/1950
  

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 56575	09/14/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 24582	05/07/2021
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
Individuals	FS-1500-9, FS-1500-9a, FS-1500-10c, FS-1500-11, FS-1500-13, FS-1500-14, FS-1500-14a, FS-1500-21b, FS-1500-16a, FS-1500-16b, FS-1500-35, FS-1500-17a, FS-1500-23, FS-1500-19, FS-1500-10, SF-424 (R&R), FS-1500-15, FS-1500-15a, FS-1500-12, FS-1500-13a, FS-1500-13b, FS-1500-16, FS-1500-16f, FS-1500-16g, FS-1500-21, FS-1500-21a, FS-1500-21c, FS-1500-21d, FS-1500-17b, FS-1500-17c, FS-1500-18, SF-424 (Individual), FS-1500-22A, FS-1500-22B, FS-1500-22, FS-1500-34	Financial Plan Long Form ,   Application for Federal Assistance (Individual) ,   Application for Federal Assistance (Research & Related) ,   Optional Project Progress Report ,   Modification of Grant or Agreement ,   Certification Regarding Lobbying ,   Challenge Cost Share Agreement ,   Cooperative Forest Road Agreement ,   Road Project Agreement ,   Non Funded Challenge Cost Share Agreement ,   Collection Agreement ,   Cooperative Research and Development Agreement ,   Joint Venture Agreement ,   International Joint Venture ,   Participating Agreement ,   Participating Agreement for Fuels or Noxious Weed Treatment ,   Non Funded Participating Agreement ,   Master Stewardship Agreement ,   Stewardship Agreement SPA ,   Stewardship Agreement Financial Plan ,   Stewardship Agreement ,   Stewardship Agreement (Short Form) ,   Agreements Financial Plan (Short) ,   Agreements Financial Plan (Medium Form) ,   Collection Agreement Financial Plan ,   Master Participating Agreement ,   Participating Agreement Supplemental Project Agreement ,   Memorandum of Understanding ,   Memorandum of Understanding for Cooperative Frequency Use ,   Cost-Reimbursable Agreement ,   Material Transfer Agreement ,   Nondisclosure Agreement ,   Financial Capability Questionnaire ,   Financial Capability Checklist ,   Financial Capability Checklist for State Agencies and Individuals ,   Grant Equipment Justification and Certification Statement
Private Sector - Federal/Non-Federal Financial Assistance Instruments	FS-1500-23, FS-1500-34, FS-1500-35, FS-1500-11b, FS-1500-23, FS-1500-22, FS-1500-22a, SF-424 (R&R), FS-1500-10c, FS-1500-11a, FS-1500-16g, FS-1500-21d, SF-424, FS-1500-16e , FS-1500-16d, FS-1500-16f, FS-1500-21, FS-1500-21a, FS-1500-21b, FS-1500-10a , FS-1500-13b , FS-1500-13a , FS-1500-17c, FS-1500-10b , FS-1500-13, FS-1500-14, FS-1500-16, FS-1500-10, FS-1500-11, FS-1500-12, FS-1500-15, FS-1500-17a, FS-1500-17b, FS-1500-19, FS-1500-9, FS-1500-18, FS-1500-14a , FS-1500-16a , FS-1500-16b , FS-1500-16c , FS-1500-7 , FS-1500-8 , FS-1500-8a , FS-1500-9a , FS-1500-21c , FS-1500-15a, FS-1500-22B	Challenge Cost-Share Agreement ,   Collection Agreement ,   Cost-Reimbursable Agreement ,   Cooperative Research and Development Agreement ,   Joint Venture Agreement ,   Participating Agreement ,   Modification Form ,   Cooperative Forest Road Agreement ,   Memorandum of Understanding ,   Financial Plan (form A) ,   Financial Plan (form B) ,   Collection Agreement Financial Plan ,   FS 1500-7 Cooperative Fire Agreement.doc ,   FS 1500-8 Cooperative Law Enforcement Agreement ,   FS 1500-8a Cooperative Law Enforcement AOP.doc ,   FS 1500-9a Road Project Agreement ,   FS 1500-10a Master Challenge Cost Share Agreement ,   FS 1500-10b Challenge Cost Share SPA ,   FS 1500-13a Material Transfer Agreement.doc ,   FS 1500-13b Nondisclosure Agreement ,   FS 1500-14a International Joint Venture Agreement ,   FS 1500-16a Master Participating Agreement ,   FS 1500-16b Participating Agreement SPA ,   FS 1500-16c Participating Agreement with Interpretive Association ,   FS 1500-17c Financial Plan Medium Form ,   Memorandum of Understanding for Cooperative Frequency Usage ,   Master Participating Agreement with Interpretative Associations ,   Participating Agreement Supplemental Project Agreement with Interpretive Associations ,   Participating Agreement for Fuels or Noxious Weed Treatment ,   Master Stewardship Agreement ,   Stewardship Agreement Supplemental Project Agreement ,   Stewardship Financial Plan ,   Stewardship Agreement ,   Application for Federal Assistance ,   Application for Federal Assistance – Research ,   Optional Project Progress Report ,   Financial Capability Questionaire ,   Financial Capability Checklist ,   Grant Equipment Justification and Certification Statement ,   Certification Regarding Lobbying ,   Non-Funded Challenge Cost Share Agreement ,   Reimbursable Collection Agreement with Rocky Mountian Elk Foundation ,   Advance Collection Agreement, Rocky Mountain Elk Foundation ,   Non Funded Participating Agreement ,   Stewardship Agreement (Short Form) ,   Optional Project Progress Report ,   Financial Capability Checklist for State Government Agencies
State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments	FS-1500-22A, FA-1500-36, FS-1500-36a, FS-1500-36b, FS-1500-37, FS-6500-235, FS-1500-34, FS-1500-35, FS-1500-10c, FS-1500-16g, FS-1500-21d, FS-1500-23, FS-1500-22, FS-1500-22b, Supplemental Provisions, SF-424, SF-424 (R&R), FS-1500-15a, FS-1500-9a, FS-1500-10a, FS-1500-13a, FS-1500-13b, FS-1500-16a, FS-1500-13, FS-1500-14, FS-1500-9, FS-1500-17b, FS-1500-12, FS-1500-11, FS-1500-18, FS-1500-16, FS-1500-7, FS-1500-8a, FS-1500-15, FS-1500-17a, FS-1500-10, FS-1500-19, FS-1500-8, FS-1500-11A, FS-1500-16e, FS-1500-11B, FS-1500-14A, FS-1500-16c, FS-1500-16d, FS-1500-16f, FS-1500-10b, FS-1500-16b, FS-1500-17c, FS-1500-21, FS-1500-21a, FS-1500-21b, FS-1500-21c, FS-1500-22	Challenge Cost-Share Agreement ,   Collection Agreement ,   Cost-Reimbursable Agreement ,   Cooperative Research and Development Agreement ,   Joint Venture Agreement ,   Participating Agreement ,   Coooperative Law Enforcement Agreement ,   Modification Form ,   Cooperative Fire Protection Agreement ,   Cooperative Law Enforcement AOP ,   Cooperative Forest Road Agreement ,   Memorandum of Understanding ,   Financial Plan A ,   Financial Plan B ,   Collection Agreement Financial Plan ,   Road Project Agreement ,   Master Challenge Cost Share Agreement ,   Material Transfer Agreement ,   Nondisclosure Agreement ,   Memorandum of Understanding for Cooperative Frequency Usage ,   Challenge Cost Share Supplemental Project Agreement ,   Master Participating Agrement ,   Participating Agreement Supplemental Project Agreement ,   Agreement Financial Plan (Medium Form) ,   Master Stewardship Agreement ,   Stewardship Agreement Supplemental Project Agreement ,   Stewardship Financial Plan ,   Stewardship Agreement ,   Collection Agreement RMEF Reimbursable ,   Collection Agrement RMEF Advance ,   International Joint Venture Agreement ,   Participating Agreement with Interpretive Association ,   Master Participating Agreement with Interpretive Association ,   Participating Agreement SPA with Interpretive Association ,   Participating Agreement for Fuels or Noxious Weed Treatment ,   Application for Federal Assistance ,   Application for Federal Assistance (Research & Related) ,   Optional Project Progress Report ,   Financial Capability Questionaire ,   Financial Capability Checklist for State Government Agencies Only ,   Grant Equipment Justification and Certification Statement ,   Certification Regarding Lobbying ,   Non Funded Challenge Cost Share Agreement ,   Non Funded Participating Agreement ,   Stewardship Agreements (Short Form) ,   Supplemental Provisions to the 7600A ,   Good Neighbor Agreement ,   Good Neighbor Agreement Master Farm Bill Agreement ,   Good Neighbor Agreement Supplemental Project Agreement ,   Good Neighbor Agreement Appropriations Act Agreement ,   De-obligation and Closeout Request Form ,   Financial Capability Questionnaire ,   Financial Capability Checklist

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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	4,890	4,890	0	0	0	0
Annual Time Burden (Hours)	42,445	42,445	0	0	0	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:

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Annual Cost to Federal Government: $468,563

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.     No

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.     No

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: 06/21/2021

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