Ams-71

AMS-71_PRS.xlsx

Pandemic Response and Safety Program (PRS

AMS-71

OMB: 0581-0326

Document [xlsx]
Download: xlsx | pdf















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.
TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.







Pandemic Response and Safety Program (PRS) (NEW) 0581-NEW




DATE PREPARED


June 11, 2021
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT
ANNUAL BURDEN








REPORTS RECORDS





















TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-
SECTION OF DESCRIPTION (If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS
REGS.




so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)








RESPONDENT



KEEPER
(A) (B) (C) (D) (E) (F) (G) (H) (I) (J) (K)
7 USC 1621 & 2 CFR 200 STANDARDIZED FORMS FOR ALL AMS GRANT PROGRAMS (Line entry represents totals only for PRS) (NEW)









Request for Applications (RFA) (Reading) None 200,000 1.0000 200,000.00 1.0000 200,000.00

0.00

Application for Federal Assistance (approved under OMB No. 4040-0004) SF 424 200,000 1.0000 200,000.00 1.1000 220,000.00

0.00

Notice of Award and Grant Agreement (approved under OMB No. 0581-0240) AMS 33 200,000 1.0000 200,000.00 0.5833 116,660.00

0.00












SUBTOTAL
600,000 2 600,000.00 2 536,660.00 0.00
0.00

TOTAL OF ALL PAGES
1,400,000 4 1,400,000.00 4 1336660.00 200,000.00
200,000.00
TOTAL - COLUMNS "F" AND "I" = OMB 831, 13 b; COLUMNS "H" AND "K" = OMB 831, 13c


1,600,000.00
1,536,660.00















































INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.
TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.







Pandemic Response and Safety Program (PRS) (NEW) 0581-NEW




DATE PREPARED


June 11, 2021
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT
ANNUAL BURDEN








REPORTS RECORDS





















TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-
SECTION OF DESCRIPTION (If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS
REGS.




so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)








RESPONDENT



KEEPER
(A) (B) (C) (D) (E) (F) (G) (H) (I) (J) (K)

Request for Advance or Reimbursement in ezFedGrants (approved under OMB No. 4040-0012) SF 270 200,000 1.0000 200,000.00 1.0000 200,000.00

0.00

Federal Financial Report (approved under OMB No. 4040-0014) SF 425 200,000 1.0000 200,000.00 1.0000 200,000.00

0.00

Recordkeeping None




200000.00 1.000 200,000.00
7 USC 1621 & 2 CFR 200 COMPETITIVE AMS GRANT PROGRAM: PRS ONLY (NEW)









SUBTOTAL
400,000 0 400,000.00 0 400,000.00 200000.00 1.00 200000.00













































INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.
TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.







Pandemic Response and Safety Program (PRS) (NEW) 0581-NEW




DATE PREPARED


June 11, 2021
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT
ANNUAL BURDEN








REPORTS RECORDS





















TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-
SECTION OF DESCRIPTION (If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS
REGS.




so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)








RESPONDENT



KEEPER
(A) (B) (C) (D) (E) (F) (G) (H) (I) (J) (K)

PRS Specific Terms and Conditions (Reading) None 200,000 1.0000 200,000.00 1.0000 200,000.00

0.00

PRS Specific Checklist None 200,000 1.0000 200,000.00 1.0000 200,000.00

0.00

SUBTOTAL
400,000 2 400,000.00 2 400,000.00 0
0.00













































INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.
TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.







Pandemic Response and Safety Program (PRS) (NEW) 0581-NEW




DATE PREPARED


June 11, 2021
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT
ANNUAL BURDEN








REPORTS RECORDS





















TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-
SECTION OF DESCRIPTION (If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS
REGS.




so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)








RESPONDENT



KEEPER
(A) (B) (C) (D) (E) (F) (G) (H) (I) (J) (K)

N/A




















SUBTOTAL
0 0 0.00 0 0.00 0
0.00
File Typeapplication/vnd.openxmlformats-officedocument.spreadsheetml.sheet
File Modified0000-00-00
File Created0000-00-00

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