Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
American Rescue Plan Act Emergency Rural Health Care Grant Program Modified 15389 71681 0 Other-Application Submission Non-Form
Other-Other Reporting Requirements - Non-Form
Form AD Form 1047 Certification Regarding Debarment, Suspension, and Other Responsibility Matters
Form and Instruction RD 3570-3 Community Facilities Grant Agreement
Form and Instruction RD 442-2 Statement of Budget, Income and Equity
Form and Instruction RD 442-3 Balance Sheet
Form and Instruction RD 442-7 Operating Budget
Total burden requested under this ICR: 15389 71681 0  
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