Information Collection

7 CFR 1734, Subparts A,B,C, and D, Distance Learning and Telemedicine Loan and Grant Program

IC 43527 under ICR 201902-0572-002 · OMB 0572-0096.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0572-0096 can be found here:

Documents and Forms

Document Name Document Type
Form Non Forms - Docume 7 CFR 1734, Subparts A,B,C, and D, Distance Learning and Telemedicine Loan and Grant Program Form and Instruction
Non Forms - Docume DLT Applicatioon Guide 2019 FY2019_DLT Reg_App_Guide.pdf www.rd.usda.gov/files/FY2019_Reg_App_Guide.pdf Form and Instruction
AD1049 Certification Regarding Drug-Free Workplace AD_1049-V1.0.pdf Form
AD-1047 Certification Regarding Debarment and Suspension AD_1047-V1.0.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	7 CFR 1734, Subparts A,B,C, and D, Distance Learning and Telemedicine Loan and Grant Program	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 1734

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Non Forms - Documents	DLT Applicatioon Guide 2019	FY2019_DLT Reg_App_Guide.pdf	https://www.rd.usda.gov/files/FY2019_Reg_App_Guide.pdf	Yes	Yes	Fillable Printable
Form	AD1049	Certification Regarding Drug-Free Workplace	AD_1049-V1.0.pdf		Yes	No	Fillable Printable
Form	AD-1047	Certification Regarding Debarment and Suspension	AD_1047-V1.0.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: 190	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: 17 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	4,104	0	4,104
Annual IC Time Burden (Hours)	10,381	-650	11,031
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.