Value-Added Producer Grants - Business

Value Added Producer Grant Program

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0570-0064 can be found here:

Documents and Forms

Document Name Document Type
Form AD 1047 Value-Added Producer Grants - Business Form
AD 1047 Certification Regarding Debarment, Suspension and Other AD1047-F-01-92-0064.docx Form
AD 1048 Certification Regarding Debarment, Suspension, Inelgibli AD1048-F-01-92-0064.docx Form
AD 1049 Certification Regarding Drug-Free Workplace Requirements AD1049-F-05-90-0064.docx Form
RD 400-4 Assurance Agreement RD0400-0004.pdf Form
RD 1942-46 Letter of Intent to Meet Conditions RD1942-0046.pdf Form
RD 1940-1 Request for Obligation of Funds RD1940-0001.pdf Form

Information Collection (IC) Details

IC Title:	Value-Added Producer Grants - Business	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 7 CFR 4284

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	AD 1047	Certification Regarding Debarment, Suspension and Other Responsibility Matters - Primary Covered Transaction	AD1047-F-01-92-0064.docx	Yes	No	Fillable Printable
Form	AD 1048	Certification Regarding Debarment, Suspension, Inelgiblity and Voluntary Exclusion - Lower Tier Covered Tranaction	AD1048-F-01-92-0064.docx	Yes	No	Fillable Printable
Form	AD 1049	Certification Regarding Drug-Free Workplace Requirements (Grants) Alternative I - For Grantees Other Than Individuals	AD1049-F-05-90-0064.docx	Yes	No	Fillable Printable
Form	RD 400-4	Assurance Agreement	RD0400-0004.pdf	Yes	No	Fillable Printable
Form	RD 1942-46	Letter of Intent to Meet Conditions	RD1942-0046.pdf	Yes	No	Fillable Printable
Form	RD 1940-1	Request for Obligation of Funds	RD1940-0001.pdf	Yes	No	Fillable Printable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 247	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Farms, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 10 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	3,294	1,814	1,480
Annual IC Time Burden (Hours)	49,049	15,376	33,673
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.