OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

American Rescue Plan Act Emergency Rural Health Care Grant Program

IC 247396 under ICR 202202-0575-002 · OMB 0575-0200.

Documents and Forms
Document Name
Document Type
Other-Application Submission Non-For
Other-Application Submission Non-For
Other-Other Reporting Requirements -
Other-Other Reporting Requirements -
Form
Form
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

American Rescue Plan Act Emergency Rural Health Care Grant Program
 
No Unchanged
 
Required to Obtain or Retain Benefits
 
7 CFR 1940

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Application Submission Non-Form 0575-0200 - Application Submissions- Non Forms.docx No   Paper Only
Other-Other Reporting Requirements - Non-Form 0575-0200 -Reporting Requirements -Non Forms.docx No   Paper Only
Form AD Form 1047 Certification Regarding Debarment, Suspension, and Other Responsibility Matters AD-1047 Section 508 Compliant.pdf Yes Yes Fillable Printable
Form and Instruction RD 3570-3 Community Facilities Grant Agreement RD 3570-3.pdf Yes Yes Fillable Printable
Form and Instruction RD 442-2 Statement of Budget, Income and Equity RD 442-2.pdf Yes Yes Fillable Printable
Form and Instruction RD 442-3 Balance Sheet RD 442-3.pdf Yes Yes Fillable Printable
Form and Instruction RD 442-7 Operating Budget RD 442-7.pdf Yes Yes Fillable Printable

Community and Social Services Community and Regional Development

USDA/RD-1 Current or Prospective Producers or Landowners, Applicants, Borrowers, Grantees, Tenants, and other participants in RD programs.  84 FR 21315

1,092 0
   
State, Local, and Tribal Governments
 
   100 %

  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 15,389 0 0 0 0 15,389
Annual IC Time Burden (Hours) 71,681 0 0 0 0 71,681
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.