Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
State and Local Governments Modified 207 281 0 Form AD-1047 Certificate Regarding Debarment
Form AD-1048 Certification Regarding Debarment, Suspension and other Responsibility Matters - Lower Tier Covered Transactions.
Form AD-1049 Certification Regarding Drug-Free Workplace Requirements (Grrants) Alternative I - for Grantees Other Than Individuals
Form and Instruction RD Instruction 1940Q A-1 Certification for Contracts, Grants, and Loans
Form RD 400-1 Equal opportunity Agreement
Form RD 400-4 Assurance Agreement
Form RD 442-22 Opinion of Counsel Regarding Right of Way
Form RD 1942-46 Letter of Intent to Meet Conditions
Form and Instruction SF 424 Application for Federal Assistance
Form and Instruction RUS Bulletin 1780-12 RUS Bulletin 1780-12
Form None RAVG ANTHC Grant Agreement
Form None RAVG SOA Grant Agreement
non-profit / private sector Modified 138 188 0 Form AD -1047 Certification Regarding Debarment
Form AD- 1048 Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Transaction
Form AD - 1049 Certification Regarding Drug-Free Workplace
Form and Instruction RD Instruction 1940Q A-1 Certification for Contracts, Grants and Loans REgarding Lobbying
Form RD 400-1 Equal Opportunity Agreement
Form RD 400-4 Assurance Agreement
Form RD 442-22 Opinion of COunsel relative to RIght-of-Way & Easments
Form RD 1942-46 Letter of Intent to Meet Conditions
Form and Instruction SF 424 Application for Federal Assistance
Form and Instruction RUS Bulletin 1780-12 RUS Bulletin 1780-12
Form None RAVG SOA Grant Agreement
Form None RAVG ANTHC Grant Agreement
Total burden requested under this ICR: 345 469 0  
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