| USDA - RUS |
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Title of Information Document |
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OMB No. |
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Special Evaluation Assistance for Rural Communities and Households Program (SEARCH) |
0572-New |
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| SUMMARY OF INFORMATION COLLECTION |
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Date Prepared |
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December-09 |
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| INSTRUCTIONS: |
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> |
(f) TOTAL |
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(h) TOTAL |
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(k) TOTAL |
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| Use this form when a single information collection document involves multiple reporting and |
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> |
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= (e) Average |
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= (g) Average |
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= (j) Average |
| recordkeeping requirements. |
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> |
(d) TOTAL |
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(f) TOTAL |
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(i) TOTAL |
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| IDENTIFICATION OF REPORTING AND RECORDKEEPPING REQUIREMENTS |
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ANNUAL BURDEN |
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FORM |
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REPORTS |
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RECORDS |
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NO(s) |
NO. OF |
NO. OF |
TOTAL |
HOURS |
TOTAL |
NO. OF |
ANNUAL |
TOTAL |
| SECTION OF |
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(If "none" |
RESPON- |
RESPONSES |
ANNUAL |
PER |
HOURS |
RECORD- |
HOURS PER |
RECORD- |
| NOFA |
DESCRIPTION |
so state) |
DENTS |
PER |
RESPONSES |
RESPONSE |
(Col. f & g) |
KEEPERS |
RECORD- |
KEEPING |
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RESPON- |
(Col. d & e) |
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KEEPER |
HOURS |
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DENT |
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(Col. i & j) |
| (a) |
(b) |
(c) |
(d) |
(e) |
(f) |
(g) |
(h) |
(i) |
(j) |
(k) |
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Burden associated with this package |
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NON-FORM BURDEN |
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Project Narrative |
Written |
50 |
1 |
50 |
2.00 |
100 |
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Supporting documentation |
Written |
50 |
1 |
50 |
6.00 |
300 |
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Certification Regarding Debarment |
AD-1047 |
40 |
1 |
40 |
0.25 |
10 |
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Certification Regarding Drug-Free Workplace |
AD-1049 |
40 |
1 |
40 |
0.25 |
10 |
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Certification for Contracts, Grants and Loans Regarding Lobbying |
Written |
40 |
1 |
40 |
0.25 |
10 |
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Certification Regarding Prohibited Tying Arrangements |
Written |
40 |
1 |
40 |
0.25 |
10 |
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Agreements for professional services |
Written |
40 |
1 |
40 |
4.00 |
160 |
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Relationship or Assocation with RUS Employees |
Written |
40 |
1 |
40 |
0.25 |
10 |
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Contracts for other services |
Written |
40 |
1 |
40 |
2.00 |
80 |
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Grant Agreement |
Written |
40 |
1 |
40 |
1.00 |
40 |
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Audits |
Written |
10 |
1 |
10 |
8.00 |
80 |
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Management report |
Written |
30 |
1 |
30 |
8.00 |
240 |
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Burden hours associated with this package |
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50 |
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820 |
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1,050 |
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Page 1 |
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FORMS APPROVED UNDER OTHER OMB NUMBERS |
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Equal Opportunity Agreement |
RD 400-1 |
40 |
1 |
40 |
0.17 |
7 |
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(0575-0018) |
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Assurance Agreement |
RD 400-4 |
40 |
1 |
40 |
0.25 |
10 |
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(0575-0018) |
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Application for Federal Assistance |
SF 424 |
50 |
1 |
50 |
1.00 |
50 |
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(4040-0004) |
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Budget Information - Non-Construction Programs |
SF 424A |
50 |
1 |
50 |
1.00 |
50 |
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(4040-0006) |
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Assurances - Non-Construction Programs |
SF 424B |
50 |
1 |
50 |
1.00 |
50 |
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(4040-0007) |
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Operating Budget |
RD 442-7 |
50 |
1 |
50 |
5.00 |
250 |
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(0575-0015) |
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Agreement for Engineering Services |
1942-19 |
40 |
1 |
40 |
4.00 |
160 |
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(0575-0015) |
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Resolution of Members or Stockholders |
RD 1942-8 |
40 |
1 |
40 |
1.00 |
40 |
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(0575-0015) |
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Total burden associated with other packages |
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360 |
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617 |
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Page 2 |
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