| 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) | 0581-0326 | |||||||||||||
| DATE PREPARED | ||||||||||||||
| December 7, 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) | |||||||||||||
| 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) | 0581-0326 | |||||||||||||
| DATE PREPARED | ||||||||||||||
| December 7, 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 | |||||||||||||
| 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) | 0581-0326 | |||||||||||||
| DATE PREPARED | ||||||||||||||
| December 7, 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) (approved under OMB 0581-0326) | None | 200,000 | 1.0000 | 200,000.00 | 1.0000 | 200,000.00 | 0.00 | |||||||
| PRS Specific Checklist (approved under OMB 0581-0326) | 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) | ||||||||||||||
| 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) | ||||
| N/A | ||||||||||||||
| SUBTOTAL | 0 | 0 | 0.00 | 0 | 0.00 | 0 | 0.00 | |||||||
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |