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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-I: 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.
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TITLE OF INFORMATION COLLECTION DOCUMENT |
OMB NO. |
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Temporary Bridge Funding Opportunity Program |
0596-NEW |
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DATE PREPARED |
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October 5, 2022 |
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IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT |
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ANNUAL BURDEN |
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REPORTS |
RECORDS |
RESPONDENT COST |
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TOTAL |
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FORMS NO (S) |
NO. OF |
NO OF |
TOTAL ANNUAL |
HOURS |
TOTAL |
NO. OF |
ANNUAL |
RECORD- |
COST |
TOTAL |
SECTION OF |
DESCRIPTION |
(If "none" |
RESPONDENTS |
RESPONSES |
RESPONSES |
PER |
HOURS |
RECORD- |
HOURS PER |
KEEPING HOURS |
PER |
COST |
REGS. |
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so state) |
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PER |
(Col. D x E) |
RESPONSE |
(Col. F x G) |
KEEPERS |
RECORD- |
(Col. I x J) |
HOUR |
(Col. H x L) |
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RESPONDENT |
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KEEPER |
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(A) |
(B) |
(C) |
(D) |
(E) |
(F) |
(G) |
(H) |
(I) |
(J) |
(K) |
(L) |
(M) |
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Temporary Bridge Funding Application |
FS-1500-48 |
100 |
1.00 |
100.00 |
3.250 |
325.00 |
0 |
0.000 |
0.00 |
40.90 |
$13,292.50 |
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Application for Federal Assistance |
SF-424 |
50 |
1.00 |
50.00 |
1.250 |
62.50 |
1 |
0.250 |
0.25 |
40.90 |
$2,556.25 |
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Budget Information for Non-Construction Programs |
SF-424A |
50 |
1.00 |
50.00 |
1.000 |
50.00 |
1 |
0.250 |
0.25 |
40.90 |
$2,045.00 |
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Certificate Regarding Lobbying Activities |
FS-1500-35 |
50 |
1.00 |
50.00 |
0.250 |
12.50 |
1 |
0.250 |
0.25 |
40.90 |
$511.25 |
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Financial Capability Questionnaire |
FS-1500-22 |
50 |
1.00 |
50.00 |
0.250 |
12.50 |
1 |
0.250 |
0.25 |
40.90 |
$511.25 |
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Screenshot of active SAM.gov registration |
None |
50 |
1.00 |
50.00 |
0.250 |
12.50 |
1 |
0.250 |
0.25 |
40.90 |
$511.25 |
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Interim Project Progress Report |
None |
50 |
1.00 |
50.00 |
0.750 |
37.50 |
1 |
0.750 |
0.75 |
40.90 |
$1,533.75 |
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Federal Financial Report |
SF-425 |
50 |
1.00 |
50.00 |
0.750 |
37.50 |
1 |
0.750 |
0.75 |
40.90 |
$1,533.75 |
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SUBTOTAL |
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450.00 |
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550.00 |
1.00 |
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0.25 |
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$15,848.75 |
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TOTAL OF ALL PAGES |
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450.00 |
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550.00 |
1.00 |
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0.25 |
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$15,848.75 |
TOTAL - COLUMNS "F" AND "I" = OMB 831, 13 b; COLUMNS "H" AND "K" = OMB 831, 13c |
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451.00 |
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550.25 |
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