Information Collection

General Administrative Requirements for Assistance Programs: State, Local, Tribal Governments

IC 23551 under ICR 202405-2030-001 · OMB 2030-0020.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 190-F-04-001 General Administrative Requirements for Assistance Programs: State, Local, Tribal Governments	Form and Instruction
190-F-04-001 US EPA Payment Request epa_form_190_f_04_001.pdf	Form and Instruction
4700-4 Pre-award Compliance Review Report for All Applicants epa_form_4700_4_fill-sign.pdf	Form and Instruction
5700-52A MBE/WBE Utilization Under Federal Grants and Cooperative epa_form_5700_52a.pdf	Form and Instruction
5700-53 Lobbying and Litigation Certificate epa_form_5700_53_fill-sign.pdf	Form and Instruction
5700-54 Key Contacts Form epa_form_5700_54.pdf	Form and Instruction
6600-01 Limited Scope Administrative and Financial Review Q epa_form_6600_01.docx	Form
6600-06 Certification Regarding Lobbying epa_form_6600_06_fill-sign.pdf	Form
6600-08A Certificate of Indirect Costs for State and Local Grants epa_form_6600_08A-fillable.pdf	Form
NCER Form 5 EPA ORD Current and Pending Support Report ncer_form_5.pdf	Form

IC Title:

Agency IC Tracking Number:

0938.23

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 2 CFR 200 2 CFR 1500 40 CFR 30 40 CFR 33 40 CFR 35

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	190-F-04-001	US EPA Payment Request	epa_form_190_f_04_001.pdf	Yes	Yes	Fillable Printable
Form and Instruction	4700-4	Pre-award Compliance Review Report for All Applicants	epa_form_4700_4_fill-sign.pdf	Yes	No	Fillable Printable
Form and Instruction	5700-52A	MBE/WBE Utilization Under Federal Grants and Cooperative Agreements	epa_form_5700_52a.pdf	Yes	Yes	Fillable Printable
Form and Instruction	5700-53	Lobbying and Litigation Certificate	epa_form_5700_53_fill-sign.pdf	Yes	No	Fillable Printable
Form and Instruction	5700-54	Key Contacts Form	epa_form_5700_54.pdf	Yes	Yes	Fillable Printable
Form	6600-01	Limited Scope Administrative and Financial Review Q	epa_form_6600_01.docx	Yes	Yes	Fillable Printable
Form	6600-06	Certification Regarding Lobbying	epa_form_6600_06_fill-sign.pdf	Yes	Yes	Fillable Printable
Form	6600-08A	Certificate of Indirect Costs for State and Local Grants	epa_form_6600_08A-fillable.pdf	Yes	Yes	Fillable Printable
Form	NCER Form 5	EPA ORD Current and Pending Support Report	ncer_form_5.pdf	Yes	Yes	Fillable Printable

Line of Business: Environmental Management

Subfunction: Pollution Prevention and Control

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 6,868

Number of Respondents for Small Entity: 5,494

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 85 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	35,007	24,572	10,435
Annual IC Time Burden (Hours)	211,352	145,158	66,194
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.