Information Collection

Airport Improvement Grants Certification and Representations

IC 236381 under ICR 202304-2120-002 · OMB 2120-0569.

Documents and Forms

Document Name Document Type
Form 5100-128 Airport Improvement Grants Certification and Representations Form and Instruction
5100-128 Agreement on State Sponsorship and Airport Sponsor Oblig faa-form-5100-128-state-sponsorship-2020.pdf www.faa.gov/forms/index.cfm/go/document.information/documentID/1027486 Form and Instruction
5100-128 Agreement on State Sponsorship and Airport Sponsor Oblig faa-form-5100-128-state-sponsorship-2020.pdf www.faa.gov/forms/index.cfm/go/document.information/documentID/1027486 Form and Instruction
5100-129 Construction Project Final Acceptance - Airport Improvem faa-form-5100-129-sponsor-cert-final-project-2020.pdf www.faa.gov/forms/index.cfm/go/document.information/documentID/1027487 Form and Instruction
5100-129 Construction Project Final Acceptance - Airport Improvem faa-form-5100-129-sponsor-cert-final-project-2020.pdf www.faa.gov/forms/index.cfm/go/document.information/documentID/1027487 Form and Instruction
5100-130 Drug-Free Workplace - Airport Improvement Program Sponso faa-form-5100-130-sponsor-cert-drug-free-2020.pdf www.faa.gov/forms/index.cfm/go/document.information/documentID/1027488 Form and Instruction
5100-130 Drug-Free Workplace - Airport Improvement Program Sponso faa-form-5100-130-sponsor-cert-drug-free-2020.pdf www.faa.gov/forms/index.cfm/go/document.information/documentID/1027488 Form and Instruction
5100-131 Equipment and Construction Contracts - Airport Improveme faa-form-5100-131-sponsor-cert-equip-constr-2020.pdf www.faa.gov/forms/index.cfm/go/document.information/documentID/1027489 Form and Instruction
5100-131 Equipment and Construction Contracts - Airport Improveme faa-form-5100-131-sponsor-cert-equip-constr-2020.pdf www.faa.gov/forms/index.cfm/go/document.information/documentID/1027489 Form and Instruction
5100-132 Project Plans and Specifications - Airport Improvement P faa-form-5100-132-sponsor-cert-plans-specs-2020.pdf www.faa.gov/forms/index.cfm/go/document.information/documentID/1027490 Form and Instruction
5100-132 Project Plans and Specifications - Airport Improvement P faa-form-5100-132-sponsor-cert-plans-specs-2020.pdf www.faa.gov/forms/index.cfm/go/document.information/documentID/1027490 Form and Instruction
5100-133 Real Property Acquisition - Airport Improvement Program faa-form-5100-133-sponsor-cert-land-2020.pdf www.faa.gov/forms/index.cfm/go/document.information/documentID/1027491 Form and Instruction
5100-133 Real Property Acquisition - Airport Improvement Program faa-form-5100-133-sponsor-cert-land-2020.pdf www.faa.gov/forms/index.cfm/go/document.information/documentID/1027491 Form and Instruction
5100-134 Selection of Consultants - Airport Improvement Program S faa-form-5100-134-sponsor-cert-consultant-2020.pdf employees.faa.gov/tools_resources/forms/index.cfm/go/document.information/documentid/1027492 Form and Instruction
5100-134 Selection of Consultants - Airport Improvement Program S faa-form-5100-134-sponsor-cert-consultant-2020.pdf employees.faa.gov/tools_resources/forms/index.cfm/go/document.information/documentid/1027492 Form and Instruction
5100-135 Certification and Disclosure Regarding Potential Conflic faa-form-5100-135-conflict-of-interest-certification-2020.pdf employees.faa.gov/tools_resources/forms/index.cfm/go/document.information/documentid/1027493 Form and Instruction
5100-135 Certification and Disclosure Regarding Potential Conflic faa-form-5100-135-conflict-of-interest-certification-2020.pdf employees.faa.gov/tools_resources/forms/index.cfm/go/document.information/documentid/1027493 Form and Instruction
5100-145 FAA Title VI Pre-Grant Award Checklist faa-form-5100-145-title-vi-pre-grant-award-checklist-2022.pdf www.faa.gov/forms/index.cfm/go/document.information/documentID/1041422 Form and Instruction
5100-145 FAA Title VI Pre-Grant Award Checklist faa-form-5100-145-title-vi-pre-grant-award-checklist-2022.pdf www.faa.gov/forms/index.cfm/go/document.information/documentID/1041422 Form and Instruction
Certification Regarding Lobbying GG_LobbyingForm-V1.1.pdf apply07.grants.gov/apply/forms/sample/GG_LobbyingForm-V1.1.pdf Form
Certification Regarding Lobbying GG_LobbyingForm-V1.1.pdf apply07.grants.gov/apply/forms/sample/GG_LobbyingForm-V1.1.pdf Form
Standard Form 1445 Labor Standards Interview SF 1445.pdf apply07.grants.gov/apply/forms/sample/GG_LobbyingForm-V1.1.pdf Form
Standard Form 1445 Labor Standards Interview SF 1445.pdf apply07.grants.gov/apply/forms/sample/GG_LobbyingForm-V1.1.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Airport Improvement Grants Certification and Representations	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 2 CFR 200 49 CFR 18

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	5100-128	Agreement on State Sponsorship and Airport Sponsor Obligations - Airport Improvement Program	faa-form-5100-128-state-sponsorship-2020.pdf	https://www.faa.gov/forms/index.cfm/go/document.information/documentID/1027486	Yes	Yes	Fillable Fileable Signable
Form and Instruction	5100-129	Construction Project Final Acceptance - Airport Improvement Program Sponsor Certification	faa-form-5100-129-sponsor-cert-final-project-2020.pdf	https://www.faa.gov/forms/index.cfm/go/document.information/documentID/1027487	Yes	Yes	Fillable Fileable Signable
Form and Instruction	5100-130	Drug-Free Workplace - Airport Improvement Program Sponsor Certification	faa-form-5100-130-sponsor-cert-drug-free-2020.pdf	https://www.faa.gov/forms/index.cfm/go/document.information/documentID/1027488	Yes	Yes	Fillable Fileable Signable
Form and Instruction	5100-131	Equipment and Construction Contracts - Airport Improvement Sponsor Certification	faa-form-5100-131-sponsor-cert-equip-constr-2020.pdf	https://www.faa.gov/forms/index.cfm/go/document.information/documentID/1027489	Yes	Yes	Fillable Fileable Signable
Form and Instruction	5100-132	Project Plans and Specifications - Airport Improvement Program Sponsor Certification	faa-form-5100-132-sponsor-cert-plans-specs-2020.pdf	https://www.faa.gov/forms/index.cfm/go/document.information/documentID/1027490	Yes	Yes	Fillable Fileable Signable
Form and Instruction	5100-133	Real Property Acquisition - Airport Improvement Program Sponsor Certification	faa-form-5100-133-sponsor-cert-land-2020.pdf	https://www.faa.gov/forms/index.cfm/go/document.information/documentID/1027491	Yes	Yes	Fillable Fileable Signable
Form and Instruction	5100-134	Selection of Consultants - Airport Improvement Program Sponsor Certification	faa-form-5100-134-sponsor-cert-consultant-2020.pdf	https://employees.faa.gov/tools_resources/forms/index.cfm/go/document.information/documentid/1027492	Yes	Yes	Fillable Fileable Signable
Form and Instruction	5100-135	Certification and Disclosure Regarding Potential Conflicts of Interest - Airport Improvement Program Sponsor Certification	faa-form-5100-135-conflict-of-interest-certification-2020.pdf	https://employees.faa.gov/tools_resources/forms/index.cfm/go/document.information/documentid/1027493	Yes	Yes	Fillable Fileable Signable
Form and Instruction	5100-145	FAA Title VI Pre-Grant Award Checklist	faa-form-5100-145-title-vi-pre-grant-award-checklist-2022.pdf	https://www.faa.gov/forms/index.cfm/go/document.information/documentID/1041422	Yes	Yes	Fillable Printable
Form	NA	Certification Regarding Lobbying	GG_LobbyingForm-V1.1.pdf	https://apply07.grants.gov/apply/forms/sample/GG_LobbyingForm-V1.1.pdf	Yes	Yes	Fillable Fileable
Form	Standard Form 1445	Labor Standards Interview	SF 1445.pdf	https://apply07.grants.gov/apply/forms/sample/GG_LobbyingForm-V1.1.pdf	Yes	Yes	Fillable Fileable Signable

Federal Enterprise Architecture Business Reference Module

Line of Business: Transportation

Subfunction: Air Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,950	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,950	400	1,550
Annual IC Time Burden (Hours)	19,500	7,100	12,400
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.