Value-Added Producer Grants - Individuals

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⚠️ Notice: This information collection may be referencing outdated material.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 - Individuals Form
AD 1047 Certification Regarding Debarment, Suspension and Other AD_1047.pdf Form
AD 1048 Certification Regarding Debarment, Suspension, Ineligibi AD_1048.pdf Form
AD 1049 Certificaqtion Regarding Drug-Free Workplace Requirement AD_1049.pdf Form
RD 400-4 Assurance Agreement RD 400-4.pdf Form
RD 1942-46 Letter of Intent to Meet Conditons RD1942-46.pdf Form
RD 1940-1 Request for Obligation of Funds RD1940-1.pdf Form
DD-214 Certificate of Release or Discharge from Active Duty us-dod-form-dd214.pdf Form
4280-2 Rural Business Cooperatvie Service Grant Agreement 4280-02.doc Form

Information Collection (IC) Details

IC Title:	Value-Added Producer Grants - Individuals	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	AD_1047.pdf	Yes	No	Fillable Printable
Form	AD 1048	Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions	AD_1048.pdf	Yes	No	Fillable Printable
Form	AD 1049	Certificaqtion Regarding Drug-Free Workplace Requirements (Grants) Alternative I - For Grantees Other Than Individuals	AD_1049.pdf	Yes	No	Fillable Printable
Form	RD 400-4	Assurance Agreement	RD 400-4.pdf	Yes	No	Fillable Printable
Form	RD 1942-46	Letter of Intent to Meet Conditons	RD1942-46.pdf	Yes	No	Fillable Printable
Form	RD 1940-1	Request for Obligation of Funds	RD1940-1.pdf	Yes	No	Fillable Printable
Form	DD-214	Certificate of Release or Discharge from Active Duty	us-dod-form-dd214.pdf	Yes	No	Fillable Printable
Form	4280-2	Rural Business Cooperatvie Service Grant Agreement	4280-02.doc	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: 56	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 5 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	356	-10	366
Annual IC Time Burden (Hours)	5,282	-167	5,449
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.