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INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.
|
TITLE OF INFORMATION COLLECTION DOCUMENT |
OMB NO. |
|
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|
|
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|
|
|
| Farm and Food Worker Relief (FFWR) Grant Program (NEW) |
0581-NEW |
|
|
|
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|
|
|
|
|
|
|
|
|
|
|
|
|
| DATE PREPARED |
|
|
|
|
|
|
|
|
|
|
|
| September 16, 2021 |
|
|
|
|
|
|
|
|
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT |
|
ANNUAL BURDEN |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
REPORTS |
RECORDS |
|
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|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
|
|
|
|
|
|
|
TOTAL |
|
|
|
|
|
|
|
|
|
|
FORMS NO (S) |
NO. OF |
NO OF |
TOTAL ANNUAL |
HOURS |
TOTAL |
NO. OF |
ANNUAL |
RECORD- |
|
|
|
|
| SECTION OF |
DESCRIPTION |
(If "none" |
RESPONDENTS |
RESPONSES |
RESPONSES |
PER |
HOURS |
RECORD- |
HOURS PER |
KEEPING HOURS |
|
|
|
|
| REGS. |
|
|
|
|
|
so state) |
|
PER |
(Col. D x E) |
RESPONSE |
(Col. F x G) |
KEEPERS |
RECORD- |
(Col. I x J) |
|
|
|
|
|
|
|
|
|
|
|
|
RESPONDENT |
|
|
|
|
KEEPER |
|
|
|
|
|
| (A) |
(B) |
(C) |
(D) |
(E) |
(F) |
(G) |
(H) |
(I) |
(J) |
(K) |
|
|
|
|
| 7 USC 1621 & 2 CFR 200 |
STANDARDIZED FORMS FOR ALL AMS GRANT PROGRAMS (Line entry represents totals only for FFWR) (NEW) |
|
|
|
0.00 |
|
0.00 |
|
|
0.00 |
|
|
|
|
|
Request for Applications (RFA) (Reading) |
None |
40 |
1.0000 |
40.00 |
4.0000 |
160.00 |
|
|
0.00 |
|
|
|
|
|
Application for Federal Assistance (OMB No. 4040-0004) |
SF 424 |
40 |
1.0000 |
40.00 |
1.0000 |
40.00 |
|
|
0.00 |
|
|
|
|
|
Notice of Award and Grant Agreement (approved under OMB No. 0581-0240) |
AMS 33 |
20 |
1.0000 |
20.00 |
0.5833 |
11.67 |
|
|
|
|
|
|
|
|
AMS General Terms and Conditions (approved under OMB No. 0581-0240) |
None |
20 |
1.0000 |
20.00 |
2.0000 |
40.00 |
|
|
0.00 |
|
|
|
|
|
Amendment Request (approved under OMB No. 0581-0240) |
None |
20 |
2.0000 |
40.00 |
1.0000 |
40.00 |
|
|
0.00 |
|
|
|
|
|
Interim Performance Report Template (approved under OMB No. 0581-0240) |
None |
20 |
2.0000 |
40.00 |
4.0000 |
160.00 |
|
|
0.00 |
|
|
|
|
|
SUBTOTAL |
|
120 |
7 |
160.00 |
12 |
411.67 |
0.00 |
|
0.00 |
|
|
|
|
|
TOTAL OF ALL PAGES |
|
392 |
38 |
884.00 |
32 |
1685.66 |
EFG:
I am confused as to how there are 10 record keepers and no burden hours assigned. Assuming the grantees are required to keep records, the number here should be 20 and then AMS should enter how many hours of burden it will be.
40.00 |
|
40.00 |
|
|
|
|
| TOTAL - COLUMNS "F" AND "I" = OMB 831, 13 b; COLUMNS "H" AND "K" = OMB 831, 13c |
|
|
|
924.00 |
|
1,725.66 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.
|
TITLE OF INFORMATION COLLECTION DOCUMENT |
OMB NO. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| Farm and Food Worker Relief (FFWR) Grant Program (NEW) |
0581-NEW |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| DATE PREPARED |
|
|
|
|
|
|
|
|
|
|
|
| September 16, 2021 |
|
|
|
|
|
|
|
|
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT |
|
ANNUAL BURDEN |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
REPORTS |
RECORDS |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
TOTAL |
|
|
|
|
|
|
|
|
|
|
FORMS NO (S) |
NO. OF |
NO OF |
TOTAL ANNUAL |
HOURS |
TOTAL |
NO. OF |
ANNUAL |
RECORD- |
|
|
|
|
| SECTION OF |
DESCRIPTION |
(If "none" |
RESPONDENTS |
RESPONSES |
RESPONSES |
PER |
HOURS |
RECORD- |
HOURS PER |
KEEPING HOURS |
|
|
|
|
| REGS. |
|
|
|
|
|
so state) |
|
PER |
(Col. D x E) |
RESPONSE |
(Col. F x G) |
KEEPERS |
RECORD- |
(Col. I x J) |
|
|
|
|
|
|
|
|
|
|
|
|
RESPONDENT |
|
|
|
|
KEEPER |
|
|
|
|
|
| (A) |
(B) |
(C) |
(D) |
(E) |
(F) |
(G) |
(H) |
(I) |
(J) |
(K) |
|
|
|
|
|
Request for Advance or Reimbursement (OMB No. 4040-0012) |
SF 270 |
20 |
10.0000 |
200.00 |
1.0000 |
200.00 |
|
|
0.00 |
|
|
|
|
|
Federal Financial Report (OMB No. 4040-0014) |
SF 425 |
20 |
3.0000 |
60.00 |
1.0000 |
60.00 |
|
|
0.00 |
|
|
|
|
|
Final Performance Report Template (approved under OMB No. 0581-0240) |
None |
20 |
1.0000 |
20.00 |
4.0000 |
80.00 |
|
|
0.00 |
|
|
|
|
|
Recordkeeping |
None |
|
|
|
|
|
EFG:
Is this in addition to the recordkeeping burden above?
20 |
2.000 |
40.00 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
SUBTOTAL |
|
40 |
11 |
220.00 |
5 |
280.00 |
20 |
|
40.00 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.
|
TITLE OF INFORMATION COLLECTION DOCUMENT |
OMB NO. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| Farm and Food Worker Relief (FFWR) Grant Program (NEW) |
0581-NEW |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| DATE PREPARED |
|
|
|
|
|
|
|
|
|
|
|
| September 16, 2021 |
|
|
|
|
|
|
|
|
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT |
|
ANNUAL BURDEN |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
REPORTS |
RECORDS |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
TOTAL |
|
|
|
|
|
|
|
|
|
|
FORMS NO (S) |
NO. OF |
NO OF |
TOTAL ANNUAL |
HOURS |
TOTAL |
NO. OF |
ANNUAL |
RECORD- |
|
|
|
|
| SECTION OF |
DESCRIPTION |
(If "none" |
RESPONDENTS |
RESPONSES |
RESPONSES |
PER |
HOURS |
RECORD- |
HOURS PER |
KEEPING HOURS |
|
|
|
|
| REGS. |
|
|
|
|
|
so state) |
|
PER |
(Col. D x E) |
RESPONSE |
(Col. F x G) |
KEEPERS |
RECORD- |
(Col. I x J) |
|
|
|
|
|
|
|
|
|
|
|
|
RESPONDENT |
|
|
|
|
KEEPER |
|
|
|
|
|
| (A) |
(B) |
(C) |
(D) |
(E) |
(F) |
(G) |
(H) |
(I) |
(J) |
(K) |
|
|
|
|
| 7 USC 1621 & 2 CFR 200 |
NON-COMPETITIVE AMS GRANT PROGRAM: FFWR ONLY (NEW) |
|
|
|
0.00 |
|
0.00 |
|
|
0.00 |
|
|
|
|
|
Peer Reviewer Application and Qualification Form |
None |
24 |
1.0000 |
24.00 |
0.3333 |
8.00 |
|
|
0.00 |
|
|
|
|
|
Peer Reviewer Conflict of Interest and Confidentiality Worksheet (Previously AMS-34 AMS Conflict of Interest and Confidentiality Statement for Grant Reviewers) |
AMS 34 |
24 |
1.0000 |
24.00 |
1.0000 |
24.00 |
|
|
0.00 |
|
|
|
|
|
Peer Reviewer AMS Grant Programs Score Sheet (Previously "Consensus Scoresheet & Comments" and "Individual Reviewer Scoresheet") |
None |
24 |
9.0000 |
216.00 |
2.0000 |
432.00 |
|
|
0.00 |
|
|
|
|
|
FFWR Narrative Submission in Grants.gov (which includes a Grant Administration template) |
None |
40 |
1.0000 |
40.00 |
10.0000 |
400.00 |
|
|
0.00 |
|
|
|
|
|
Negotiated Indirect Cost Rate Agreement (NICRA) |
None |
40 |
1.0000 |
40.00 |
0.2500 |
10.00 |
|
|
0.00 |
|
|
|
|
|
Project Beneficiaries Questionnaire |
None |
40 |
1.0000 |
40.00 |
0.3333 |
13.33 |
|
|
0.00 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
SUBTOTAL |
|
192 |
14 |
384.00 |
14 |
887.33 |
0 |
|
0.00 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.
|
TITLE OF INFORMATION COLLECTION DOCUMENT |
OMB NO. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| DATE PREPARED |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT |
|
ANNUAL BURDEN |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
REPORTS |
RECORDS |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
TOTAL |
|
|
|
|
|
|
|
|
|
|
FORMS NO (S) |
NO. OF |
NO OF |
TOTAL ANNUAL |
HOURS |
TOTAL |
NO. OF |
ANNUAL |
RECORD- |
|
|
|
|
| SECTION OF |
DESCRIPTION |
(If "none" |
RESPONDENTS |
RESPONSES |
RESPONSES |
PER |
HOURS |
RECORD- |
HOURS PER |
KEEPING HOURS |
|
|
|
|
| REGS. |
|
|
|
|
|
so state) |
|
PER |
(Col. D x E) |
RESPONSE |
(Col. F x G) |
KEEPERS |
RECORD- |
(Col. I x J) |
|
|
|
|
|
|
|
|
|
|
|
|
RESPONDENT |
|
|
|
|
KEEPER |
|
|
|
|
|
| (A) |
(B) |
(C) |
(D) |
(E) |
(F) |
(G) |
(H) |
(I) |
(J) |
(K) |
|
|
|
|
|
Accounting System and Financial Capability Questionnaire |
None |
20 |
1.0000 |
20.00 |
0.3333 |
6.67 |
|
|
0.00 |
|
|
|
|
|
AMS Grant Programs Worksheet along with SF 270 (Previously AMS Worksheet to Accompany each SF-270) |
None |
20 |
5.0000 |
100.00 |
1.0000 |
100.00 |
|
|
0.00 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
SUBTOTAL |
|
40 |
6 |
120.00 |
1 |
106.67 |
Err:522 |
|
Err:522 |
|
|
|
|