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Federal forms, ICRs, and supporting documents

Information Collection

Forms and Regulatons for Grants to States for Construction and Acquisition of State Home Facilities

IC 28939 under ICR 201104-2900-034 · OMB 2900-0661.

Documents and Forms
Document Name
Document Type
Instruction
Form and Instruction
Form
Form
Form
Form
Form and Instruction
Form and Instruction
Form and Instruction
Form
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

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Forms and Regulatons for Grants to States for Construction and Acquisition of State Home Facilities 2900-0661
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction 2900-0661 Forms_Support_List[1].docx www.va.gov/vaforms No   Printable Only
Form and Instruction 10-0388-2 CERTIFICATION OF COMPLIANCE WITH PROVISIONS OF THE DAVIS-BACON ACT 10-0388-2-fillable.pdf www.va.gov/vaforms Yes No Fillable Printable
Form and Instruction 10-0388-13 DOCUMENTS AND CERTIFICATION REQUIRED FOR STATE HOME CONSTRUCTION AND ACQUISITION GRANTS - POST-GRANT REQUIREMENTS 10-0388-13-fillable.pdf www.va.gov/vaforms Yes No Fillable Printable
Form 10-0388-3 SPACE PROGRAM ANALYSIS - NURSING HOME & DOMICILIARY 10-0388-3-fillable.pdf www.va.gov/vaforms Yes No Fillable Printable
Form 10-0388-4 ADULT DAY HEALTH CARE 10-0388-4-fillable.pdf www.va.gov/vaforms Yes No Fillable Printable
Form 10-0388-5 ADDITIONAL DOCUMENTS AND INFORMATION REQUIRED FOR STATE HOME CONSTRUCTION AND ACQUISITION GRANTS APPLICATION 10-0388-5.pdf www.va.gov/vaforms Yes No Fillable Printable
Form 10-0388-6 CERTIFICATION OF STATE MATCHING FUNDS TO QUALIFY FOR GROUP 1 ON THE PRIORITY LIST 10-0388-6.pdf www.va.gov/vaforms Yes No Fillable Printable
Form and Instruction 10-0388-7 CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS - PRIMARY COVERED TRANSACTIONS 10-0388-7.pdf www.va.gov/vaforms Yes No Fillable Printable
Form and Instruction 10-0388-8 CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS FOR GRANTEES OTHER THAN INDIVIDUALS 10-0388-8-fillable.pdf www.va.gov/vaforms Yes No Fillable Printable
Form and Instruction 10-0388-9 CERTIFICATION REGARDING LOBBYING 10-0388-9-fillable.pdf www.va.gov/vaforms Yes No Fillable Printable
Form 10-0388-10 CERTIFICATION OF COMPLIANCE WITH FEDERAL REQUIREMENTS 10-0388-10-fillable.pdf www.va.gov/vaforms Yes No Fillable Printable
Form and Instruction 10-0388-12 CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION - LOWER TIER COVERED TRANSACTIONS 10-0388-12-fillable.pdf www.va.gov/vaforms Yes No Fillable Printable
Form and Instruction 10-0338-1 Documents & Information Required for State Home Construction & Acquisition Grants-Initial Application 10-0388-1.pdf www.va.gov/vaforms Yes No Fillable Printable

Community and Social Services Community and Regional Development

 

50 0
   
State, Local, and Tribal Governments
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 50 0 0 -10 0 60
Annual IC Time Burden (Hours) 1,200 0 0 840 0 360
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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