| 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 | 0581-0331 | |||||||||||||
| DATE PREPARED | ||||||||||||||
| February 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 | 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 | 0581-0331 | |||||||||||||
| DATE PREPARED | ||||||||||||||
| February 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 | 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 | 0581-0331 | |||||||||||||
| DATE PREPARED | ||||||||||||||
| February 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 Type | application/vnd.ms-excel |
| Author | user |
| Last Modified By | Haidet, Margaret - AMS |
| File Modified | 2022-02-17 |
| File Created | 2000-01-10 |