2012 Spreadsheet

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Overview

Combined burden
Sheet2
Sheet3
Sheet4
Sheet5

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Sheet 1: Combined burden

170	1
140	2
4	8
Section of Regulation	Title	Form No (if any)	Estimated No. of Respondents	Reports Filed Annually	Total Annual Responses (D) x (E)	Estimated No. of Manhours Per Response	Estimated Total Manhours (F) x (G)	Wage Class	Total Cost (H) x (I)
(A)	(B)	(C)	(D)	(E)	(F)	(G)	(H)	(I)	(J)
	Reporting Requirements - No Forms
1944.410(a)(1)	Evidence of Capacity to Operate a MSH Program -Local/State Governments (Native American Indian Tribes) -Nonprofit Organization	Narrative Statement	20 120	1	140	0.25	35	$24	$840
1944.410(a)(2)	Organizational Documents -Local/State Governments (Native American Indian Tribes) -Nonprofit Organization	Narrative Statement	20 120	1	140	0.16	22	$24	$538
1944.410(a)(3)	Financial Statement -Local/State Governments (Native American Indian Tribes) -Nonprofit Organization	Narrative Statement	20 120	1	140	0.25	35	$24	$840
1944.410(a)(4)	Narrative Statement of the Area to be Served -Local/State Governments (Native American Indian Tribes) -Nonprofit Organization	Narrative Statement	20 120	1	140	0.25	35	$24	$840
1944.410(a)(5)	Very Low-Income Plan -Local/State Governments (Native American Indian Tribes) -Nonprofit Organization	Narrative Statement	20 120	1	140	0.5	70	$24	$1,680
1944.410(a)(7)	Survey of Lots -Local/State Governments (Native American Indian Tribes) -Nonprofit Organization	Narrative Statement	20 120	1	140	1	140	$24	$3,360
1944.410(a)(8)	List of Other Activities -Local/State Governments (Native American Indian Tribes) -Nonprofit Organization	Narrative Statement	20 120	1	140	0.25	35	$24	$840
1944.410(a)(9)	Statement Identifying Need, Amount of Funds and Projected Time Period -Local/State Governments (Native American Indian Tribes) -Nonprofit Organization	Narrative Statement	7 103	1	110	8.5	935	$24	$22,440
1944.410(a)(d), Exhibit D	Self-Help Technical Assistance Grant Predevelopment Agreement -Local/State Governments (Native American Indian Tribes) -Nonprofit Organization	Narrative Statement	5 10	1	15	0.5	8	$24	$180
1944.411( c)	Statement of Compliance, OMB Circulars and Department Regulations -Local/State Governments (Native American Indian Tribes) -Nonprofit Organization	Narrative Statement	7 103	1	110	0.16	18	$24	$422
1944.411(g)	Establishing Interest Bearing Accounts -Local/State Governments (Native American Indian Tribes) -Nonprofit Organization	Narrative Statement	7 103	4	440	0.25	110	$24	$2,640
1944.417(b) & Exhibit B	Evaluation Report of Self-Help Grants -Local/State Governments (Native American Indian Tribes) -Nonprofit Organization	Narrative Statement	7 103	4	440	1	440	$24	$10,560
1944.419( c)	Request for Evaluation Review -Local/State Governments (Native American Indian Tribes) -Nonprofit Organization	Letter	2 8	1	10	0.16	2	$24	$38
1944.420( c)	Revised Budget -Local/State Governments (Native American Indian Tribes) -Nonprofit Organization	Narrative Statement	5 30	1	35	1	35	$24	$840
1944.422(a)	Audit Report, Non-Profit Organizations -Local/State Governments (Native American Indian Tribes) -Nonprofit Organization	Written	5 100	1	105	15	1,575	$24	$37,800
1944.422(b)	Audit Report, Local Governments and Indian Tribes -Local/State Governments (Native American Indian Tribes) -Nonprofit Organization	Narrative Statement	2 6	1	8	15	120	$24	$2,880
1944.427, Exhibit E	Grantees' Self-Evaluation -Local/State Governments (Native American Indian Tribes) -Nonprofit Organization	Narrative Statement	7 103	1	110	1	110	$24	$2,640
1944-I, Exhibit F	Application for Site Option Loan -Local/State Governments (Native American Indian Tribes) -Nonprofit Organization	Narrative Statement	1 1	1	1	1	1	$24	$24
	SUBTOTAL				2364		3,725		$89,402
	Reporting Requirements - Recordkeeping
1944.411(f)	Agreement to Establish a Certified Recordkeeping System -Local/State Governments (Native American Indian Tribes) -Nonprofit Organization	Narrative Statement	7 103	1	110	0.16	18	$24	$422
1944.411(h)	Agreement Between Grantee and Families -Local/State Governments (Native American Indian Tribes) -Nonprofit Organization	Narrative Statement	7 103	1	110	0.16	18	$24	$422
1944.420, Exhibit C	Amendment to the Self-Help Technical Assistance Grant Agreement -Local/State Governments (Native American Indian Tribes) -Nonprofit Organization	Narrative Statement	7 103	1	110	0.16	18	$24	$422
1944-I, Exhibit A	Self-Help Technical Assistance Grant Agreement -Local/State Governments (Native American Indian Tribes) -Nonprofit Organization	Narrative Statement	7 103	1	110	0.08	9	$24	$211
	SUBTOTAL				440		62		$1,478
	Reporting Requirements - Forms Approved Under Other OMB Numbers
1944.410(a)	Application for Federal Assistance -Local/State Governments (Native American Indian Tribes) -Nonprofit Organization	SF-424 (0348-0043)	20 120	1	140	1	140	$24	$3,360
1944.410(a)(6)	Budget Information Non-Construction Programs -Local/State Governments (Native American Indian Tribes) -Nonprofit Organization	SF-424A (0348-0044)	20 120	1	140	3	420	$24	$10,080
1944.410(e)	Equal Opportunity Agreement -Local/State Governments (Native American Indian Tribes) -Nonprofit Organization	RD 400-1 (0575-0018)	20 120	1	140	0.16	22	$24	$538
1944.411(d)	Assurance Agreement -Local/State Governments (Native American Indian Tribes) -Nonprofit Organization	RD 400-4 (0575-0018)	20 120	1	140	0.25	35	$24	$840
1944.411(d)	Assurances – Nonconstruction Programs -Local/State Governments (Native American Indian Tribes) -Nonprofit Organization	SF-424B (0348-0040)	20 120	1	140	0.25	35	$24	$840
1944.417(a)(2)	Request for Advance or Reimbursement -Local/State Governments (Native American Indian Tribes) -Nonprofit Organization	SF-270 (0348-0004)	20 120	1	140	1	140	$24	$3,360
1944.426(a)(2)	Federal Financial Report -Local/State Governments (Native American Indian Tribes) -Nonprofit Organization	SF-425 (0348-0038)	20 120	1	140	1.5	210	$24	$5,040
1944.410(b)(1)(ii)	Request for Environmental Information -Local/State Governments (Native American Indian Tribes) -Nonprofit Organization	RD 1940-20 (0575-0094)	20 120	1	140	6	840	$24	$20,160
1944.410(b)(2)(iv)	Affirmative Fair Housing Marketing Plan -Local/State Governments (Native American Indian Tribes) -Nonprofit Organization	HUD 935.2 (2529-0013)	20 120	1	140	3	420	$24	$10,080
	Total Annual Responses				2,364		3725		$89,402
	Total Recordkeeping Burden				440		62		$1,478
	Total Burden This Docket				2,804		3787		$90,880

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Sheet 2: Sheet2

Type	Section of Regulation	Title	Form No (if any)	Estimated No. of Respondents	Reports Filed Annually	Total Annual Responses (D) x (E)	Estimated No. of Manhours Per Response	Estimated Total Manhours (F) x (G)	Wage Class	Total Cost (H) x (I)
	(A)	(B)	(C)	(D)	(E)	(F)	(G)	(H)	(I)	(J)
TA Grant Application
1	3551.55 (b) (1)	Application for Federal Assistance	SF-424	170	1	170	0.75	127.5	$15.00	$1,912.50
1	3551.55 (b) (2)	Evidence of capacity to operate a MSH program	Narrative statement	170	1	170	0.25	42.5	$15.00	$637.50
1	3551.55 (b) (3)	Organizational Documents	Narrative statement	170	1	170	0.16	27.2	$15.00	$408.00
1	3551.55 (b) (3)	Financial statement	Narrative statement	170	1	170	0.25	42.5	$15.00	$637.50
1	3551.55 (b) (10)	Commercial credit report	Narrative statement	170	1	170	0.16	27.2	$15.00	$408.00
1	3551.55 (b) (4)	Evidence of need and demand	Narrative statement	170	1	170	1	170	$15.00	$2,550.00
1	3551.55 (b) (5)	Evidence of land availability	Narrative statement	170	1	170	1	170	$15.00	$2,550.00
1	3551.55 (b) (7)	Program budget	SF-424A or equivalent	170	1	170	3	510	$15.00	$7,650.00
1	3551.55 (b) (8)	Housing plans and cost estimates	Narrative statement	170	1	170	1	170	$15.00	$2,550.00
1	3551.55 (b) (9)	Monthly activities schedule	Narrative statement	170	1	170	1	170	$15.00	$2,550.00
1	3551.55 (b) (11)	Assurance Agreement	RD 400-4	170	1	170	0.25	42.5	$15.00	$637.50
1	3551.55 (b) (11) (i)	Equal Opportunity Agreement	RD 400-1	170	1	170	0.25	42.5	$15.00	$637.50
1	3551.55 (b) (11)	Assurances – Nonconstruction Programs	SF-424B	170	1	170	0.25	42.5	$15.00	$637.50
1	3551.55 (b) (11)	Drug-Free Workplace	AD-1049	170	1	170	0.16	27.2	$15.00	$408.00
1	3551.55 (b) (11)	Certification regarding debarment, suspension, ineligibility and voluntary exclusion	AD-1047	170	1	170	0.16	27.2	$15.00	$408.00
1	3551.55 (b) (11) (iii)	Conflict-of-interest Disclosure	Narrative statement	170	1	170	0.16	27.2	$15.00	$408.00
1	3551.55 (b) (11) (iv)	Disclosure of Lobbying Activities	RD 1940-Q	170	1	170	0.16	27.2	$15.00	$408.00
1	3551.55 (b) (12)	Evidence of multi-funded status/cost allocation plan	Letter/Narrative statement	170	1	170	0.5	85	$15.00	$1,275.00
1	3551.55 (b) (13)	Number of homes/ Factors for awards	Narrative statement/ Scoring summary sheet	170	1	170	1	170	$15.00	$2,550.00
1	3551.9/3551.55 (d) (3)	TA Grant Agreement	Narrative Statement	170	1	170	0.08	13.6	$15.00	$204.00
TA Grant Closing
2	3551.55 (d) (1)	Personnel Information	Narrative statement	140	1	140	0.25	35	$15.00	$525.00
2	3551.55 (d) (2)	Evidence of insurance and fidelity bonding	Narrative statement	140	1	140	0.25	35	$15.00	$525.00
2	3551.55 (d) (2)	Evidence of accounting and record keeping system (compliance with 7 CFR 3015 or 7 CFR 3016)	Narrative statement	140	1	140	0.25	35	$15.00	$525.00
2	3551.55 (d) (3)	Authorization from the Board of Directors	Narrative statement	140	1	140	0.16	22.4	$15.00	$336.00
2	3551.55 (d) (4)	Evidence of checking account	Narrative statement	140	1	140	0.25	35	$15.00	$525.00
2	3551.55 (d) (5)	Member’s agreement	Narrative statement	140	1	140	0.16	22.4	$15.00	$336.00
2	3551.55 (d) (6)	Evidence 1st group participating families qualified for mortgage financing	Narrative statement	140	1	140	0.16	22.4	$15.00	$336.00
2	3551.55 (d) (7)	Building specifications	Narrative statement	140	1	140	1	140	$15.00	$2,100.00
2	3551.55 (d) (8)	Affirmative Fair Housing Marketing Plan	HUD 935.2	140	1	140	1	140	$15.00	$2,100.00
2	3551.55 (d) (9)	Agreement of compliance with all applicable Federal statutes and regulations	Narrative statement	140	1	140	0.16	22.4	$15.00	$336.00
2	3551.55 (d) (10)	Evidence addressed RHS environmental review findings	Narrative statement	4	1	4	0.5	2	$15.00	$30.00
2	3551.55 (d) (11)	Evidence addressed RHS Civil Rights Impact analysis findings	Narrative statement	2	1	2	0.5	1	$15.00	$15.00
TA Grant Program Administration
3	3551.103 (a) and (b)	Request for Obligation of Funds	RD 1940-1	130	1	130	0.25	32.5	$15.00	$487.50
3	3551.103 (a) and (b)	Grantee Request for ongoing payments/ Includes SHARES update	SHARES/ SF-270	130	12	1560	1	1560	$15.00	$23,400.00
6	3551.103 (c)	Grantee request for payment varying significantly from draw schedule	Letter with SF-270	45	12	540	0.5	270	$15.00	$4,050.00
3	3551.151(a)	Generate quarterly SHARES report	SHARES report and narrative statement	130	4	520	0.5	260	$15.00	$3,900.00
4	3551.104 (c) (2)	Grantee audit – Nonprofit organizations	Narrative statement	90	1	90	15	1350	$15.00	$20,250.00
5	3551.104 (c) (1)	Grantee audit – State, local and Indian tribal government	Narrative statement	10	1	10	15	150	$15.00	$2,250.00
7	3551.152 (a)	Grant Amendment requests	Letter / Amendment to Self-Help Technical Assistance Grant	15	1	15	0.16	2.4	$15.00	$36.00
7	3551.152 (b)	Work-out agreements for grantees designated High Risk	Narrative statement	15	1	15	1	15	$15.00	$225.00
3	3551.106 (a)	Grant Closeout – Grantee program documentation	Final equipment inventory / Certification of records retention	130	1	130	0.5	65	$15.00	$975.00
3	3551.106 (a) 3551.106 (b) 3551.106 (c)	Grant Closeout – Grantee financial documentation	SF-269A / Certification of borrower account closeout / Final Audit	130	1	130	1.5	195	$15.00	$2,925.00
3	3551.106 (a)	Grant Closeout – Final Grantee Evaluation	Final SHARES entry	130	1	130	1	130	$15.00	$1,950.00
3	3551.106	Request for RHS Evaluation Review	Letter	15	1	15	0.16	2.4	$15.00	$36.00
Total TA Grant Application Burden				3400	20	3400	11.54	1961.8		$29,427.00
Total TA Grant Closing Burden				1406	12	1406	4.64	512.6		$7,689.00
Total TA Grant Program Administration Burden				970	37	3285	36.57	4032.3		$60,484.50
Total TA Burden				5776	69	8091	52.75	6506.7		$97,600.50

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Sheet 3: Sheet3

Type	Section of Regulation	Title	Form No. (if any)	Estimated No. of Respondents	Reports Filed Annually	Total Annual Responses (D) x (E)	Estimated No. of Manhours Per Response	Estimated Total Manhours (F) x (G)	Wage Class	Total Cost (H) x (I)
	(A)	(B)	(C)	(D)	(E)	(F)	(G)	(H)	(I)	(J)
11	3551.251 (g) (1)	Loan application	SF-424	4	1	4	0.75	3	$15.00	$45.00
11	3551.251 (g) (2) (i)	Resolution authorizing application for a site option loan	Narrative statement	4	1	4	0.25	1	$15.00	$15.00
11	3551.251 (g) (2) (ii)	Copy of proposed option or schedule of proposed options	Narrative statement	4	1	4	0.25	1	$15.00	$15.00
12	3551.251 (i)	Loan closing	Loan agreement	1	1	1	0.25	0.25	$15.00	$3.75
Total Site Option Loan				13	4	13	1.5	5.25		$78.75

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Sheet 4: Sheet4

Type	Section of Regulation	Title	Form No. (if any)	Estimated No. of Respondents	Reports Filed Annually	Total Annual Responses (D) x (E)	Estimated No. of Manhours Per Response	Estimated Total Manhours (F) x (G)	Wage Class	Total Cost (H) x (I)
	(A)	(B)	(C)	(D)	(E)	(F)	(G)	(H)	(I)	(J)
13	3551.201 (f) (2) (i)	Application for Federal Assistance	SF-424	70	1	70	0.75	52.5	$15.00	$787.50
13	3551.201 (f) (2) (ii)	Evidence of demonstrated capacity to operate a MSH program	Narrative statement	70	1	70	0.25	17.5	$15.00	$262.50
13	3551.201 (f) (2) (iii)	Certificate of incorporation	Narrative statement	70	1	70	0.16	11.2	$15.00	$168.00
13	3551.201 (f) (2) (iv)	Tax-exempt certification	Narrative statement	70	1	70	0.16	11.2	$15.00	$168.00
13	3551.201 (f) (2) (v)	Articles of incorporation and Bylaws	Narrative statement	70	1	70	0.16	11.2	$15.00	$168.00
13	3551.201 (f) (2) (vi)	Certificate of good standing	Narrative statement	70	1	70	0.16	11.2	$15.00	$168.00
13	3551.201 (f) (2) (vii)	Organization identifying information	Narrative statement	70	1	70	0.16	11.2	$15.00	$168.00
13	3551.201 (f) (2) (viii)	Financial statement	Narrative statement	70	1	70	0.25	17.5	$15.00	$262.50
13	3551.201 (f) (2) (ix)	Credit report	Narrative statement	70	1	70	0.16	11.2	$15.00	$168.00
13	3551.201 (f) (2) (x)	Land availability	Narrative statement	70	1	70	0.5	35	$15.00	$525.00
13	3551.201 (f) (2) (xi)	Evidence of interest by families	Narrative statement	70	1	70	0.5	35	$15.00	$525.00
13	3551.201 (f) (2) (xii)	Monthly activity schedule	Narrative statement	70	1	70	0.5	35	$15.00	$525.00
13	3551.201 (f) (2) (xii)	Proposed budget	Narrative statement	70	1	70	0.5	35	$15.00	$525.00
13	3551.201 (f) (2) (xiii)	Conflict-of-interest disclosure	Narrative statement	70	1	70	0.16	11.2	$15.00	$168.00
13	3551.201 (f) (2) (xiv)	Disclosure of lobbying activities	RD 1940-Q	70	1	70	0.16	11.2	$15.00	$168.00
13	3551.9	Grant Agreement	Narrative Statement	70	1	70	0.08	5.6	$15.00	$84.00
15	3551.201 (h) (2)	Predevelopment grantee closeout: Final accounting of funds	Narrative statement	25	1	25	1	25	$15.00	$375.00
Total Predevelopment Grant Burden				1145	17	1145	5.61	347.7		$5,215.50

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Sheet 5: Sheet5

	Estimated No. of Respondents	Reports Filed Annually	Total Annual Responses (D) x (E)	Estimated No. of Manhours Per Response	Estimated Total Manhours (F) x (G)	Wage Class	Total Cost (H) x (I)
Total TA Burden	5776	69	8091	52.75	6506.7		$97,600.50
Total Predevelopment Grant Burden	1145	17	1145	5.61	347.7		$5,215.50
Total Site Option Loan	13	4	13	1.5	5.25		$78.75
TOTAL	6934	90	9249	59.86	6859.65		$102,894.75