OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Suspension and Debarment and Drug-Free Workplace Certifications

ICR 202204-0505-001 · OMB 0505-0027 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Form AD-1047 Suspension and Debarment and Drug-Free Workplace Certifications Form and Instruction Modified Repair queued
0505-0027-'22 SStmt Final (USDA SD DFWP Certs).docx Supporting Statement A Uploaded 2022-04-29 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
217590 Suspension and Debarment and Drug-Free Workplace Certifications Form and Instruction Modified
ICR Details
0505-0027 202204-0505-001
Received in OIRA 201910-0505-002
USDA/OCFO
Suspension and Debarment and Drug-Free Workplace Certifications
Revision of a currently approved collection   No
Regular 04/29/2022
  Requested Previously Approved
36 Months From Approved 04/30/2022
1 1
1 1
0 0
To certify information on applicant suitability concerning distribution of financial assistance in compliance with Federal Suspension and Debarment and Drug-Free Workplace regulations.
US Code: 41 USC 8101 Name of Law: Drug-Free Workplace
  
None
Not associated with rulemaking
  87 FR 3755 01/25/2022
87 FR 25214 04/28/2022
No
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 1 1 0 0 0 0
Annual Time Burden (Hours) 1 1 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$0
No
    No
    Yes
No
No
No
No
Martha Burton 202 205-6182
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
04/29/2022