Information Collection

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

IC 241078 under ICR 202407-0970-009 · 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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Key Personnel Minimum Qualifications Checklist and Attestation (Form A-14)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Mandatory

CFR Citation:

Information Collection 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 %

	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

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.