Information Collection

7 CFR 4284-F, Rural Cooperative Development Grant

IC 1647 under ICR 201306-0570-001 · OMB 0570-0006.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0570-0006 can be found here:

Documents and Forms

Document Name Document Type
Form AD-1047 7 CFR 4284-F, Rural Cooperative Development Grant Form
AD-1047 Certification Regarding Debarment, Suspension, and Other AD1047-F-01-92.docx Form
AD-1048 Certification Regarding Debarment, Suspension, Ineligibi AD1048-F-01-92.docx Form
AD-1049 CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS AD1049-F-05-90.docx Form
Sf LLL DISCLOSURE OF LOBBYING ACTIVITIES sflll.pdf Form
1942-46 LETTER OF INTENT TO MEET CONDITIONS RD1942-0046_100600V02.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	7 CFR 4284-F, Rural Cooperative Development Grant	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 7 CFR 4284.510-516 7 CFR 4284.11-16

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	AD-1047	Certification Regarding Debarment, Suspension, and Other Responsibility Matters - Primary Covered Transactions	AD1047-F-01-92.docx	Yes	No	Fillable Printable
Form	AD-1048	Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions	AD1048-F-01-92.docx	Yes	No	Fillable Printable
Form	AD-1049	CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS (GRANTS) ALTERNATIVE I - FOR GRANTEES OTHER THAN INDIVIDUALS	AD1049-F-05-90.docx	Yes	No	Fillable Printable
Form	Sf LLL	DISCLOSURE OF LOBBYING ACTIVITIES	sflll.pdf	Yes	No	Fillable Printable
Form	1942-46	LETTER OF INTENT TO MEET CONDITIONS	RD1942-0046_100600V02.pdf	Yes	No	Fillable Printable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 73	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	406	-299	705
Annual IC Time Burden (Hours)	7,838	-1,487	9,325
Annual IC Cost Burden (Dollars)	0	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.