Ams-71

AMS-71_Farmworker -10-29.xls

Farm and Food Workers Relief Grant Program

AMS-71

OMB: 0581-0331

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.















Farm and Food Worker Relief (FFWR) Grant Program (NEW) 0581-NEW
















DATE PREPARED










September 16, 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 FFWR) (NEW)


0.00
0.00

0.00




Request for Applications (RFA) (Reading) None 40 1.0000 40.00 4.0000 160.00

0.00




Application for Federal Assistance (OMB No. 4040-0004) SF 424 40 1.0000 40.00 1.0000 40.00

0.00




Notice of Award and Grant Agreement (approved under OMB No. 0581-0240) AMS 33 20 1.0000 20.00 0.5833 11.67







AMS General Terms and Conditions (approved under OMB No. 0581-0240) None 20 1.0000 20.00 2.0000 40.00

0.00




Amendment Request (approved under OMB No. 0581-0240) None 20 2.0000 40.00 1.0000 40.00

0.00




Interim Performance Report Template (approved under OMB No. 0581-0240) None 20 2.0000 40.00 4.0000 160.00

0.00




SUBTOTAL
120 7 160.00 12 411.67 0.00
0.00




TOTAL OF ALL PAGES
392 38 884.00 32 1685.66 EFG: I am confused as to how there are 10 record keepers and no burden hours assigned. Assuming the grantees are required to keep records, the number here should be 20 and then AMS should enter how many hours of burden it will be. 40.00
40.00



TOTAL - COLUMNS "F" AND "I" = OMB 831, 13 b; COLUMNS "H" AND "K" = OMB 831, 13c


924.00
1,725.66































































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.















Farm and Food Worker Relief (FFWR) Grant Program (NEW) 0581-NEW
















DATE PREPARED










September 16, 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 (OMB No. 4040-0012) SF 270 20 10.0000 200.00 1.0000 200.00

0.00




Federal Financial Report (OMB No. 4040-0014) SF 425 20 3.0000 60.00 1.0000 60.00

0.00




Final Performance Report Template (approved under OMB No. 0581-0240) None 20 1.0000 20.00 4.0000 80.00

0.00




Recordkeeping None




EFG: Is this in addition to the recordkeeping burden above? 20 2.000 40.00



















SUBTOTAL
40 11 220.00 5 280.00 20
40.00




























































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.















Farm and Food Worker Relief (FFWR) Grant Program (NEW) 0581-NEW
















DATE PREPARED










September 16, 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 NON-COMPETITIVE AMS GRANT PROGRAM: FFWR ONLY (NEW)


0.00
0.00

0.00




Peer Reviewer Application and Qualification Form None 24 1.0000 24.00 0.3333 8.00

0.00




Peer Reviewer Conflict of Interest and Confidentiality Worksheet (Previously AMS-34 AMS Conflict of Interest and Confidentiality Statement for Grant Reviewers) AMS 34 24 1.0000 24.00 1.0000 24.00

0.00




Peer Reviewer AMS Grant Programs Score Sheet (Previously "Consensus Scoresheet & Comments" and "Individual Reviewer Scoresheet") None 24 9.0000 216.00 2.0000 432.00

0.00




FFWR Narrative Submission in Grants.gov (which includes a Grant Administration template) None 40 1.0000 40.00 10.0000 400.00

0.00




Negotiated Indirect Cost Rate Agreement (NICRA) None 40 1.0000 40.00 0.2500 10.00

0.00




Project Beneficiaries Questionnaire None 40 1.0000 40.00 0.3333 13.33

0.00



















SUBTOTAL
192 14 384.00 14 887.33 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.


































DATE PREPARED



















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)




Accounting System and Financial Capability Questionnaire None 20 1.0000 20.00 0.3333 6.67

0.00




AMS Grant Programs Worksheet along with SF 270 (Previously AMS Worksheet to Accompany each SF-270) None 20 5.0000 100.00 1.0000 100.00

0.00

















































SUBTOTAL
40 6 120.00 1 106.67 Err:522
Err:522



File Typeapplication/vnd.ms-excel
Authoruser
Last Modified ByHaidet, Margaret - AMS
File Modified2021-10-28
File Created2000-01-10

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