Form Approved - OMB No. 0563-XXXX
This form is available electronically. (Expiration Date 01/31/XXXX)
RMA-301 U.S. DEPARTMENT OF AGRICULTURE |
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(proposal 1) Risk Management Agency |
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PROPOSAL SUMMARY |
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NOTE: |
The following statement is made in accordance with the Privacy Act of 1974 (5 USC 552a) and the Paperwork Reduction Act of 1995, as amended. The authority for requesting the following information is under section 522(d)(3)(F) of the Federal Crop Insurance Act (Act) (7 U.S.C. 1522(d)(3)(F). The information will be used to monitor cooperative and partnership agreement holders in their performance of tasks specified under the terms of the agreements. The information will also be used by RMA to report educational activity under the Government Performance Results Act. Furnishing the requested information is mandatory. Failure to furnish the requested information will result in the suspension of the project. This information may be provided to other agencies, IRS, Department of Justice, or other State and Federal law enforcement agencies, and in response to a court magistrate or administrative tribunal. The provisions of criminal and civil fraud statutes, including 18 USC 286, 287, 371, 641, 651, 1001; 15 USC 714m; and 31 USC 3729, may be applicable to the information provided.
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0563-XXXX. The time required to complete this information collection is estimated to average .50 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and, and completing and reviewing the collection of information. |
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1. RMA Program Name |
2. CFDA Number |
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3. Short Project Title (Maximum 15 Words) |
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4. Affected Area |
5. Funding Requested |
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6. Primary Project Objective |
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7. Administrative Contact |
8. Organization |
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9. Title of Administrative Contact |
10. Telephone Number |
11. Email |
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12. Street Address of Administrative Contact |
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13. City |
14. State |
15. Zip |
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16. Program Manager |
17. Organization |
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18. Title of Program Manager |
19. Telephone Number |
20. Email |
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21. Street Address of Program Manager |
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22. City |
23. State |
24. Zip |
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25. (See Instructions listed in RFA, otherwise, Leave Blank) |
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26. (See Instructions listed in RFA, otherwise, Leave Blank) |
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Proposal Summary (Maximum 250 Words):
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The U.S. Department of Agriculture (USDA) prohibits discrimination in all its program and activities on the basis of race, color, national origin, age, disability, and where applicable, sex, marital status, familial status, parental status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or part of an individual’s income is derived from any public assistance program. (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communication of program information ( Braille, large print, audiotape, etc.) should contact USDA’s TARGET Center at (202) 720-2600 (voice and TDD). To file a complaint of discrimination, write to USDA, Director, Office of Civil Rights, 1400 Independence Avenue, SW., Washington, DC 20250-9410, or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.
RMA-301 (proposal 1) Page 2 of 2
INSTRUCTIONS |
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Item Number |
INFORMATION TO BE ENTERED |
1 |
Enter the RMA program name. |
2 |
Enter the Catalog of Federal Domestic Assistance (CFDA) number of the program under which assistance is requested, as found in the program announcement (RFA), if applicable. |
3 |
Enter a brief descriptive title of the project (15 words maximum). |
4 |
List the geographic areas affected using the categories (e.g., specific cities, counties, states, RMA Regional Office, etc.) may be specified in the RFA. |
5 |
Enter the total funding amount requested. For multiple year projects, enter the total of all years. |
6 |
Enter the primary project objective or special emphasis topic as specified in the RFA. |
7 |
Enter the name of the administrative person that would be contacted on matters regarding fiscal questions related to the project. |
8 |
Enter the organization name of the administrative contact person. |
9 |
Enter the job title of the administrative contact person. |
10 |
Enter the telephone number of the administrative contact person. |
11 |
Enter the email address of the administrative contact person. |
12 |
Enter the street or mailing address of the administrative contact person. |
13 |
Enter the City of the administrative contact person. |
14 |
Enter the State of the administrative contact person. |
15 |
Enter the Zip of the administrative contact person. |
16 |
Enter the name of the program manager (e.g. principal investigator, project director, etc.) for the project. |
17 |
Enter the organization name of the program manager. |
18 |
Enter the job title of the program manager. |
19 |
Enter the telephone number of the program manager. |
20 |
Enter the email address of the program manager. |
21 |
Enter the mailing address of the program manager. |
22 |
Enter the City of the program manager. |
23 |
Enter the State of the program manager. |
24 |
Enter the Zip of the program manager. |
25 |
Follow instructions listed in the RFA, otherwise, leave blank |
26 |
Follow instructions listed in the RFA, otherwise, leave blank |
27 |
Enter the proposal or project summary. It must not exceed 250 words and must contain a summary of the proposed activity suitable for dissemination to the public. It should be a self-contained description of the project. This summary must not include any proprietary or confidential information. |
File Type | application/msword |
File Title | UNITED STATES DEPARTMENT OF AGRICULTURE |
Author | Craig Witt |
Last Modified By | Lon Burke |
File Modified | 2008-06-13 |
File Created | 2008-06-13 |