View Information Collection (IC)
Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
non-profit / private sector
Agency IC Tracking Number:
0572
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
7 CFR 1784
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
AD -1047
Certification Regarding Debarment
AD-1047 2018.pdf
http://www.rurdev.usda.gov/FormsAndPublications.html
Yes
No
Fillable Printable
Form
AD- 1048
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Transaction
AD-1048 2018.pdf
http://www.rurdev.usda.gov/FormsAndPublications.html
Yes
No
Fillable Printable
Form
AD - 1049
Certification Regarding Drug-Free Workplace
AD-1049 2018.pdf
http://www.rurdev.usda.gov/FormsAndPublications.html
Yes
No
Fillable Printable
Form and Instruction
RD Instruction 1940Q A-1
Certification for Contracts, Grants and Loans REgarding Lobbying
RD Instruction 1940Q A-1 2018.pdf
http://www.rurdev.usda.gov/FormsAndPublications.html
Yes
No
Fillable Printable
Form
RD 400-1
Equal Opportunity Agreement
RD400-1 2018.pdf
http://www.rurdev.usda.gov/FormsAndPublications.html
Yes
No
Fillable Printable
Form
RD 400-4
Assurance Agreement
RD 400-4 2018.PDF
http://www.rurdev.usda.gov/FormsAndPublications.html
Yes
No
Fillable Printable
Form
RD 442-22
Opinion of COunsel relative to RIght-of-Way & Easments
RD0442-0022 2018.pdf
http://www.rurdev.usda.gov/FormsAndPublications.html
Yes
No
Fillable Printable
Form
RD 1942-46
Letter of Intent to Meet Conditions
RD1942-46 2018.pdf
http://www.rurdev.usda.gov/FormsAndPublications.html
Yes
No
Fillable Printable
Form and Instruction
SF 424
Application for Federal Assistance
SF424 FORM AND INSTRUCTION.pdf
http://www.grants.gov
Yes
No
Fillable Printable
Form and Instruction
RUS Bulletin 1780-12
RUS Bulletin 1780-12
RUS_Bulletin_1780-12.pdf
http://www.rurdev.usda.gov/FormsAndPublications.html
Yes
No
Fillable Printable
Form
None
RAVG SOA Grant Agreement
RAVG SOA Grant Agreement FINAL.docx
http://www.rurdev.usda.gov/FormsAndPublications.html
No
Fillable Printable
Form
None
RAVG ANTHC Grant Agreement
RAVG ANTHC Grant Agreement FINAL.doc
http://www.rurdev.usda.gov/FormsAndPublications.html
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Community and Regional Development
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
10
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
0 %
Approved
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
138
0
0
0
0
138
Annual IC Time Burden (Hours)
188
0
0
0
0
188
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
SF 424C - Budget Information - Construciton Programs
SF424C_2_0-V2.0 (1).pdf
09/05/2018
SF 424D - Assurances - Construction Programs
SF424D-V1.1 2018.pdf
09/05/2018
SF LLL - Disclosure of Lobbying Activities
SFLLL_1_2-V1.2 2018.pdf
09/05/2018
SF-424A, “Budget Information--Non-Construction Programs
SF424A-V1.0 2018.pdf
09/05/2018
SF-424B, “Assurances--Non-construction Programs
SF424B-V1.1 2018.pdf
09/05/2018
RUS Form 266 “Compliance Assurance
UP_ET_form_266 2018.pdf
09/05/2018
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.