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Federal forms, ICRs, and supporting documents

Information Collection

State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments

IC 185951 under ICR 202210-0596-001 · OMB 0596-0217.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form FS-1500-22
State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments		 Form and Instruction
Form FS-1500-22
Financial Capability Questionaire State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments		 Form and Instruction
Form FS-1500-22b
Financial Capability Checklist for State Government Agencies Only State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments		 Form
Form FS-1500-34
Grant Equipment Justification and Certification Statement State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments		 Form
Form FS-1500-35
Certification Regarding Lobbying State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments		 Form
Form FS-1500-22A
Financial Capability Checklist State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments		 Form
FS-1500-22 Financial Capability Questionaire
FS 1500-22 Financial Capability Questionaire 2.0_v1.docx 		Form and Instruction
FS-1500-22b Financial Capability Checklist for State Government Agen
FS-1500-22b Financial Capability Checklist for State Government Agencies_v1.docx 		Form
FS-1500-34 Grant Equipment Justification and Certification Statemen
FS-1500-34 Grant Equipment Justification and Certification Statement_v1.docx 		Form
FS-1500-35 Certification Regarding Lobbying
FS-1500-35 Certification Regarding Lobbying_v1.docx 		Form
FS-1500-22A Financial Capability Checklist
FS-1500-22a Financial Capability Checklist_v1.docx 		Form

Information Collection (IC) Details

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Information Collection Instruments:
table that charts list of instruments
Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction FS-1500-22 Financial Capability Questionaire FS 1500-22 Financial Capability Questionaire 2.0_v1.docx Yes Yes Fillable Printable
Form FS-1500-22b Financial Capability Checklist for State Government Agencies Only FS-1500-22b Financial Capability Checklist for State Government Agencies_v1.docx Yes Yes Fillable Printable
Form FS-1500-34 Grant Equipment Justification and Certification Statement FS-1500-34 Grant Equipment Justification and Certification Statement_v1.docx Yes Yes Fillable Printable
Form FS-1500-35 Certification Regarding Lobbying FS-1500-35 Certification Regarding Lobbying_v1.docx Yes Yes Paper Only
Form FS-1500-22A Financial Capability Checklist FS-1500-22a Financial Capability Checklist_v1.docx No   Paper Only

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 1,143 0 -861 0 0 2,004
Annual IC Time Burden (Hours) 558 0 -16,837 0 0 17,395
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.