Information Collection

Repowering Assistance Program - Individuals

IC 192374 under ICR 201010-0570-006 · OMB 0570-0066.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0570-0066 can be found here:

Documents and Forms

Document Name Document Type
Form RD 4288-4 Repowering Assistance Program - Individuals Form
RD 1940-Q Exhb A-1.pdf Other-Certification
RD 4288-4 Repowering Assistance Program Application RD 4288-4 Eligibility Application 3-8-11.docx Form
RD 4288-5 Repowering Assistance Program Agreement RD 4288-5 Agreement 1-18-11.docx Form
RD 4288-6 Repowering Assistance Program Payment Request RD 4288-6 Annual Report 1-18-11.docx Form
RD 400-1 Equal Opportunity Agreement RD_400-1.pdf Form
RD 400-4 Assurance Agreement RD_400-4.pdf Form
RD 1940-20 Request for Environmental Information RD 1940-20 Request for Environmental Info.pdf Form
AD-1047 Certification Regarding Debarment, Suspension, & other R AD-1047.pdf Form
AD-1048 Certification Regarding Debarment, Suspension, & other R AD-1048.pdf Form
SF-LLL Disclosure of Lobbying Activities SF-LLL.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Repowering Assistance Program - Individuals	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	RD 4288-4	Repowering Assistance Program Application	RD 4288-4 Eligibility Application 3-8-11.docx	Yes	No	Fillable Printable
Other-Certification			RD 1940-Q Exhb A-1.pdf	No		Paper Only
Form	RD 1940-20	Request for Environmental Information	RD 1940-20 Request for Environmental Info.pdf	Yes	No	Fillable Printable
Form	AD-1047	Certification Regarding Debarment, Suspension, & other Responsibility Matters - Primary Covrd Trans	AD-1047.pdf	Yes	No	Fillable Printable
Form	AD-1048	Certification Regarding Debarment, Suspension, & other Responsibility Matters, Lower Tier Covrd Trans	AD-1048.pdf	Yes	No	Fillable Printable
Form and Instruction	SF-LLL	Disclosure of Lobbying Activities	SF-LLL.pdf	Yes	No	Fillable Printable
Form	RD 400-1	Equal Opportunity Agreement	RD_400-1.pdf	Yes	Yes	Fillable Fileable
Form	RD 400-4	Assurance Agreement	RD_400-4.pdf	Yes	Yes	Fillable Fileable
Form	RD 4288-5	Repowering Assistance Program Agreement	RD 4288-5 Agreement 1-18-11.docx	Yes	No	Fillable Printable
Form	RD 4288-6	Repowering Assistance Program Payment Request	RD 4288-6 Annual Report 1-18-11.docx	Yes	No	Fillable Printable

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 13	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	130	130
Annual IC Time Burden (Hours)	2,612	2,612
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.