Information Collection

Key Personnel Minimum Qualifications Checklist and Attestation (Form A-14)

IC 241078 under ICR 202406-0970-006 · OMB 0970-0547.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0547 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form A-14 Key Personnel Minimum Qualifications Checklist and Attestation (Form A-14)	Form
A-14 Key Personnel Qualification Checklist and Attestation A-14 Key Personnel Qualification Checklist and Attestation_v3_ FINAL DRAFT (06.28.24).pdf	Form

IC Title:

Key Personnel Minimum Qualifications Checklist and Attestation (Form A-14)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

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	A-14	Key Personnel Qualification Checklist and Attestation	A-14 Key Personnel Qualification Checklist and Attestation_v3_ FINAL DRAFT (06.28.24).pdf		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 235

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	2,115	2,115
Annual IC Time Burden (Hours)	353	353
Annual IC Cost Burden (Dollars)	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.