Coronavirus State and Local Fiscal Recovery Funds Program

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Transfers Form - Counties and Metropolitan Cities	Form and Instruction	New	Available
Transfers Form - Non-Entitlement Units of Local Government	Form and Instruction	New	Available
Local Government Transfer Form	Form and Instruction	New	Repair queued
Request for Second Extension	Form	Unchanged	Available
Request for Extension	Form	Unchanged	Repair queued
Request for Extension Form	Form	Unchanged	Repair queued
Tribal Employment Information Form	Form and Instruction	Unchanged	Available
Tribal Employment Information Form	Form and Instruction	Unchanged	Repair queued
Title VI Assurances	Form and Instruction	Unchanged	Available
Title VI Assurances	Form and Instruction	Unchanged	Repair queued
Acceptance of Award Terms without certification	Form and Instruction	Unchanged	Available
Acceptance of Award Terms Form with certification	Form and Instruction	Unchanged	Available
Acceptance of Award Terms	Form and Instruction	Unchanged	Repair queued
Recipient Payment Information Form	Form and Instruction	Unchanged	Repair queued
Recipient Payment Form	Form and Instruction	Unchanged	Repair queued
1505-0271 Non-substantive Change Justification - LG Transfer Form 2021-09-02.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2021-09-02	Repair queued
Emergency Justification Memo - SLFRF Plan Report and Template_signed.pdf	Supplementary Document	Uploaded 2021-08-06	Repair queued
1. Emergency Justification Memo - SLFRF Perf Report and NEU template.docx	Supplementary Document	Uploaded 2021-08-02	Repair queued
1505-0271 Non-substantive Change Justification - Extension Form 2021-07-13.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2021-07-13	Repair queued
1505-0271 Non-substantive Change Justification - Extension Form 2021-06-11.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2021-06-11	Repair queued
Emergency Justification Memo_SLT Form_FINAL_signed.pdf	Supplementary Document	Uploaded 2021-05-27	Repair queued
1505-0271_SLFRP SS_Treasury Portal User Guide v1.docx	Supporting Statement A	Uploaded 2021-08-06	Repair queued
SLFRP _Emergency Justification Memo FINAL_signed.pdf	Supplementary Document	Uploaded 2021-05-08	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
249160	Local Government Transfer Form	Form and Instruction	New	Transfers Form - Counties and Metropolitan Cities
249160	Local Government Transfer Form	Form and Instruction	New	Transfers Form - Non-Entitlement Units of Local Government
249160	Local Government Transfer Form	Form and Instruction	New
248757	Non-UGLG Distribution Templates	Other-templates	Unchanged
248649	Non-entitlement units of government (NEU) Distribution Template	Other-template	Unchanged
248648	Annual Recovery Plan Performance Report	Other-template	Unchanged
247871	Request for Extension Form	Form	Unchanged	Request for Second Extension
247871	Request for Extension Form	Form	Unchanged	Request for Extension
247871	Request for Extension Form	Form	Unchanged
247652	Tribal Employment Information Form	Form and Instruction	Unchanged	Tribal Employment Information Form
247652	Tribal Employment Information Form	Form and Instruction	Unchanged
247260	Title VI Assurances	Form and Instruction	Unchanged	Title VI Assurances
247260	Title VI Assurances	Form and Instruction	Unchanged
247045	Acceptance of Award Terms	Form and Instruction	Unchanged	Acceptance of Award Terms without certification
247045	Acceptance of Award Terms	Form and Instruction	Unchanged	Acceptance of Award Terms Form with certification
247045	Acceptance of Award Terms	Form and Instruction	Unchanged
247044	Recipient Payment Form	Form and Instruction	Unchanged	Recipient Payment Information Form
247044	Recipient Payment Form	Form and Instruction	Unchanged

ICR Details

OMB Control No: 1505-0271	ICR Reference No: 202109-1505-002
Status: Historical Active	Previous ICR Reference No: 202108-1505-001
Agency/Subagency: TREAS/DO	Agency Tracking No:
Title: Coronavirus State and Local Fiscal Recovery Funds Program
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 08/06/2021
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/07/2021
Retrieve Notice of Action (NOA)	Date Received in OIRA: 09/02/2021
Terms of Clearance: Addition of the Local Government Transfer Forms to the approval under this OMB control number is being made as a non-substantive change in light of the recent emergency approval of this OMB control number

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2021	11/30/2021	11/30/2021
Responses	17,980	0	16,480
Time Burden (Hours)	51,735	0	50,235
Cost Burden (Dollars)	0	0	0

---

Abstract: Sections 602 and 603 of the Social Security Act as added by section 9901 of the American Rescue Plan Act of 2021 (the “Act”), Pub. L. No. 117-2 (Mar. 11, 2021) authorizes the Coronavirus State Fiscal Recovery Fund (CSFRF) and Coronavirus Local Fiscal Recovery Fund (CLFRF) respectively (referred to as the “Coronavirus State and Local Fiscal Recovery Funds” or “SLFRF”), which provides $350 billion in total funding to Treasury to make payments generally to States (defined to include the District of Columbia), U.S. Territories (defined to include, Puerto Rico, U.S. Virgin Islands, Guam, Northern Mariana Islands, and American Samoa), Tribes, Metropolitan cities, Counties, Consolidated Governments, and Nonentitlement units of local government (through States) (collectively the “eligible entities”) to respond to the COVID-19 public health emergency or its negative economic impact, including provide assistance to households, small business, nonprofits, and impacted industries, such as tourism, travel, and hospitality; respond to workers performing essential work during the COVID-19 pandemic by providing premium pay to eligible workers of the State, territory, tribal government, metropolitan city, county, or nonentitlement units of local government performing essential work or by providing grants to eligible employers that have eligible workers; provide government services, to the extent COVID-19 caused a reduction of revenues collected in the most recent full fiscal year of the State, territory, tribal government, metropolitan city, county, or nonentitlement units of local government; or make necessary investments in water, sewer, or broadband infrastructure. Section 602(b) of the Act prescribes that $219.8 billion must be allocated as follows: (1) $4.5 billion reserved for making payments to the U.S. Territories; (2) $20 billion reserved for making payments to Tribal governments; and (3) $195.3 billion reserved for making payments to the 50 States and the District of Columbia. Section 603(b) of the Act prescribes that $130.2 billion must be allocated as follows: (1) $45.57 billion reserved for making payments to Metropolitan cities; (2) $19.53 billion reserved for making payments to States for distribution to Nonentitlement units of local government; and (3) $65.1 billion reserved for making payments to Counties. A unit of general local government that has formed a consolidated government or is geographically (in full or in part) within the boundaries of another unit of general local government may receive a distribution from the funds reserved for making payment to a metropolitan city, nonentitlement unit of local government or county, as applicable based on the respective formula for such allocation to a metropolitan city, nonentitlement unit of local government or county. Section 602(b)(6)(A)(i) provides that Treasury shall make payments to States and U.S. Territories no later than 60 days after receipt of the required certification. Payments to tribal governments are to be distributed no later than 60 days after March 11, 2021 pursuant to section 602(b)(6)(B). Section 603(b)(7)(A) provides that Treasury shall make the first tranche of payments to metropolitan cities, counties, and States for distribution to nonentitlement units of local government no later than 60 days after March 11, 2021.

Emergency Justfication: Pursuant to the Office of Management and Budget (OMB) procedures established at 5 C.F.R. § 1320.13, the Department of the Treasury (Treasury) requests emergency processing for State and Local Fiscal Recovery Funds (SLFRF) program Recovery Plan Performance Report, the Non-entitlement units of government (NEU) distribution template and the Not units of general local government (Non-UGLG) information collection request, revising OMB Control Number 1505-0271. On March 11, 2021, the American Rescue Plan Act was signed into law, and established the Coronavirus State Fiscal Recovery Fund and Coronavirus Local Fiscal Recovery Funds, which together make up the Coronavirus State and Local Fiscal Recovery Funds (“SLFRF”) program. This program is intended to provide support to State, territorial, local, and Tribal governments in responding to the economic and public health impacts of COVID-19 and in their efforts to contain impacts on their communities, residents, and businesses. On June 17, 2020, Treasury published the Compliance and Reporting Guidance that SLFRF recipients need to comply with to fulfill their reporting requirements. As noted in the Compliance and Reporting Guidance, recipients are required to fulfill the first of those reporting requirements by August 31, 2021. Treasury is currently working on developing the reporting portal recipients will use to transmit the necessary information. The online portal is expected to go live around August 9, 2021, which will only provide recipients less than a month to fulfill their reporting obligations. Due to the need to provide guidance to recipients so they can gather the necessary information needed to be reported through the Treasury reporting portal once it opens or be posted in their public website, Treasury requests emergency processing and approval by August 6, 2021 of the Recovery Plan Performance Report, which will contain detailed project performance data, including information on efforts to improve equity and engage communities; the NEU Distribution Template, the Non-UGLG Distribution Template, which provide updates on distributions to individual NEUs and Non-UGLGs, and the associated User Guide. Due to the need for recipients to prepare and submit the report and template to Treasury expeditiously, Treasury requests emergency processing and approval of the recovery performance plan, by August 6, 2021. Given the inability to seek public comment during such a short timeframe, Treasury requests a waiver from the requirement to publish notice in the Federal Register seeking public comment.

---

Authorizing Statute(s): PL: Pub.L. 117 - 2 9901 Name of Law: American Rescue Plan Act of 2021
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 9

table that charts list of burden

IC Title	Form No.	Form Name
Acceptance of Award Terms	N/A, N/A	Acceptance of Award Terms Form with certification ,   Acceptance of Award Terms without certification
Annual Recovery Plan Performance Report
Local Government Transfer Form	N/A, N/A	Transfers Form - Non-Entitlement Units of Local Government ,   Transfers Form - Counties and Metropolitan Cities
Non-UGLG Distribution Templates
Non-entitlement units of government (NEU) Distribution Template
Recipient Payment Form	n/a	Recipient Payment Information Form
Request for Extension Form	N/A, N/A	Request for Extension ,   Request for Second Extension
Title VI Assurances	n/a	Title VI Assurances
Tribal Employment Information Form	n/a	Tribal Employment Information Form

---

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	17,980	16,480	0	1,500	0	0
Annual Time Burden (Hours)	51,735	50,235	0	1,500	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: A non-substantive change request is being submitted in order to add forms that would enable local governments to transfer SLFRF funds to their state, as allowed under section 603(c)(4) of the American Rescue Plan Act of 2021.

---

Annual Cost to Federal Government: $0

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? Yes

---

Common Form ICR:  No

---

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: 09/02/2021

---