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Federal forms, ICRs, and supporting documents

Information Collection

Forms and Regulatons for Grants to States for Construction and Acquisition of State Home Facilities

IC 28939 under ICR 202302-2900-003 · OMB 2900-0661.

Documents and Forms
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Document Type
Form and Instruction
Form and Instruction
Form and Instruction
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Information Collection (IC) Details

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Forms and Regulatons for Grants to States for Construction and Acquisition of State Home Facilities 2900-0661
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 10-0388-14 VA Checklist of Major Requirements for State Homes Construction/Acquisition Grants Form 10-0388-14 VA Checklist.pdf Yes No Fillable Printable
Form and Instruction 10-0388-1 Documents and Information Required for State Home Construction and Acquisition Grants - Initial Application Form 10-0388-1.pdf Yes No Fillable Printable
Form 10-0388-2 Certification of Compliance with Provisions of the Davis-Bacon Act Form 10-0388-2 Davis-Bacon Act.pdf Yes No Fillable Printable
Form 10-0388-3 State Home Construction Grant Program Space Program Analysis - Nursing Home & Domiciliary Form 10-0388-3 Space Program Analysis-Nursing Home and Domiciliary (1).pdf Yes No Fillable Printable
Form 10-0388-4 Sate Home Construction Grant Program Space Program Analysis - Adult Day Care Form 10-0388-4 Space Program Analysis-Adult day Health Care (1).pdf Yes No Fillable Printable
Form 10-0388-5 Additional Documents and Information Required for State Home Construction and Acquisition Grants Application Form 10-0388-5.pdf Yes No Fillable Printable
Form 10-0388-6 Certification of State Matching Funds To Qualify for Group 1 on the Priority List Form 10-0388-6 State Matching Funds.pdf Yes No Fillable Printable
Form and Instruction 10-0388-7 Certification Regarding Debarment, Suspension, and Other Responsibility Matters - Primary Covered Transactions Form 10-0388-7 Certification Regarding Debarment, Suspension and Other Responsibilities.pdf Yes No Fillable Printable
Form 10-0388-8 Certification Regarding Drug-Free Workplace Requirements for Grantees Other Than Individuals Form 10-0388-8 Certification Re. Drug-Free Workplace.pdf Yes No Fillable Printable
Form 10-0388-9 Certification Regarding Lobbying Form 10-0388-9 Certification Re. Lobbying.pdf Yes No Fillable Printable
Form 10-0388-10 Certification of Compliance With Federal Requirements - State Home Construction Grant Form 10-0388-10 Certification of Compliance with Federal Requirements.pdf Yes No Fillable Printable
Form and Instruction 10-0388-12 Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions Form 10-0388-12.pdf Yes No Fillable Printable
Form 10-0388-13 Documents and Information Required for State Home Construction and Acquisition Grants - Post-Grant Requirements Form 10-0388-13.pdf Yes No Fillable Printable

Community and Social Services Community and Regional Development

 

50 0
   
State, Local, and Tribal Governments
 
   0 %

  Requested 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 50 0 0 0 50 0
Annual IC Time Burden (Hours) 1,200 0 0 0 1,200 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.