Information Collection

7 CFR 4284-F, Rural Cooperative Development Grant

IC 1647 under ICR 201904-0570-002 · 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⚠️ Notice: This information collection may be referencing outdated material.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 1942-46 LETTER OF INTENT TO MEET CONDITIONS 7 CFR 4284-F, Rural Cooperative Development Grant Form
Form 1940-1 7 CFR 4284-F, Rural Cooperative Development Grant Form
Form 1940-1 Request for Obligation of Funds 7 CFR 4284-F, Rural Cooperative Development Grant Form
Form 1940-20 Request for Environmental Information 7 CFR 4284-F, Rural Cooperative Development Grant Form
Form AD-1047 Certification Regarding Debarment, Suspension, and Other Responsibility Matters Primary Covered Transactions 7 CFR 4284-F, Rural Cooperative Development Grant Form
Form AD-1048 Certification Regarding Debarment, Suspension, Ineligibility and Vountary Exclusion Lower Tier Covered Technician 7 CFR 4284-F, Rural Cooperative Development Grant Form
Form AD-1049 Certification Regarding Drug-Free Workplace Requirements (Grants) Alternative I - For Grantees Other Than Individuals 7 CFR 4284-F, Rural Cooperative Development Grant Form
Form RD 400-4 Assurance Agreeement 7 CFR 4284-F, Rural Cooperative Development Grant Form
1942-46 LETTER OF INTENT TO MEET CONDITIONS RD1942-0046_100600V02.pdf Form
1942-46 LETTER OF INTENT TO MEET CONDITIONS RD1942-0046_100600V02.pdf Form
1940-1 Request for Obligation of Funds RD1940-0001_100600V05.pdf Form
1940-1 Request for Obligation of Funds RD1940-0001_100600V05.pdf Form
1940-20 Request for Environmental Information RD1940-0020_060400V01.pdf Form
1940-20 Request for Environmental Information RD1940-0020_060400V01.pdf Form
AD-1047 Certification Regarding Debarment, Suspension, and Other AD-1047 DebarmentCert-PrimaryCovered.pdf Form
AD-1047 Certification Regarding Debarment, Suspension, and Other AD-1047 DebarmentCert-PrimaryCovered.pdf Form
AD-1048 Certification Regarding Debarment, Suspension, Ineligibi AD-1048 DebarmentCert-LowerTierCovered.pdf Form
AD-1048 Certification Regarding Debarment, Suspension, Ineligibi AD-1048 DebarmentCert-LowerTierCovered.pdf Form
AD-1049 Certification Regarding Drug-Free Workplace Requirements AD-1049 DrugFreeCert-Alt1.pdf Form
AD-1049 Certification Regarding Drug-Free Workplace Requirements AD-1049 DrugFreeCert-Alt1.pdf Form
RD 400-4 Assurance Agreeement RD 400-4.pdf Form
RD 400-4 Assurance Agreeement RD 400-4.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 4284.11-16 7 CFR 4284.510-516

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1942-46	LETTER OF INTENT TO MEET CONDITIONS	RD1942-0046_100600V02.pdf	Yes	No	Fillable Printable
Form	1940-1	Request for Obligation of Funds	RD1940-0001_100600V05.pdf	Yes	No	Fillable Printable
Form	1940-20	Request for Environmental Information	RD1940-0020_060400V01.pdf	Yes	No	Fillable Printable
Form	AD-1047	Certification Regarding Debarment, Suspension, and Other Responsibility Matters Primary Covered Transactions	AD-1047 DebarmentCert-PrimaryCovered.pdf	Yes	No	Fillable Printable
Form	AD-1048	Certification Regarding Debarment, Suspension, Ineligibility and Vountary Exclusion Lower Tier Covered Technician	AD-1048 DebarmentCert-LowerTierCovered.pdf	Yes	No	Fillable Printable
Form	AD-1049	Certification Regarding Drug-Free Workplace Requirements (Grants) Alternative I - For Grantees Other Than Individuals	AD-1049 DrugFreeCert-Alt1.pdf	Yes	No	Fillable Printable
Form	RD 400-4	Assurance Agreeement	RD 400-4.pdf	Yes	No	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 55	Number of Respondents for Small Entity: 27

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	471	9	0	462
Annual IC Time Burden (Hours)	7,264	0	922	6,342
Annual IC Cost Burden (Dollars)	0	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.

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].