Information Collection

Technical Assistance Training Grant Program

IC 190171 under ICR 200907-0572-005 · OMB 0572-0144.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0572-0144 can be found here:

Documents and Forms

Document Name Document Type
Form AD 1047 Technical Assistance Training Grant Program Form
RD 0400-1 Equal Opportunity Agreement 0400-01.pdf www.usda.gov/rus/water/wwforms.htm Form
RD 0400-04 Assurance Agreement 0400-04.pdf http:www.usda.gov/rus/water/wwforms.htm Form
AD 1047 Certificate of Debarment, etc. for Primary Transactions ad1047.pdf www.usda.gov/rus/water/wwforms.htm Form
AD 1049 Certificate for Drug-Free Workplace ad1049.pdf http:www.usda.gov/rus/water/wwforms.htm Form
SF LLL Disclosure for LobbyingActivities sflllin.pdf http:www.usda.gov/rus/water/wwforms.htm Form
usda 1048 Debarment of Lower Tier Transactions usda1048.pdf www.usda.gov/rus/water/wwforms.htm Form and Instruction
Grant Agreement Grant Agreement.doc Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Technical Assistance Training Grant Program	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 7 CFR 1926

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	AD 1047	Certificate of Debarment, etc. for Primary Transactions	ad1047.pdf	http://www.usda.gov/rus/water/wwforms.htm	Yes	No	Printable Only
Form	AD 1049	Certificate for Drug-Free Workplace	ad1049.pdf	http:www.usda.gov/rus/water/wwforms.htm	Yes	No	Paper Only
Form	SF LLL	Disclosure for LobbyingActivities	sflllin.pdf	http:www.usda.gov/rus/water/wwforms.htm	Yes	No	Fillable Printable
Form and Instruction	usda 1048	Debarment of Lower Tier Transactions	usda1048.pdf	http://www.usda.gov/rus/water/wwforms.htm	Yes	No	Fillable Printable
Form	None	Grant Agreement	Grant Agreement.doc		No		Paper Only
Form	RD 0400-1	Equal Opportunity Agreement	0400-01.pdf	http://www.usda.gov/rus/water/wwforms.htm	Yes	No	Printable Only
Form	RD 0400-04	Assurance Agreement	0400-04.pdf	http:www.usda.gov/rus/water/wwforms.htm	Yes	No	Printable Only

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 30	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	357	357
Annual IC Time Burden (Hours)	1,042	1,042
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.