0575-0198 Spreadsheet FY 22

0575-0198 spreadsheet 2022 10.26.22.xlsm

Community Facilities Technical Assistance and Training Grant Program

0575-0198 Spreadsheet FY 22

OMB: 0575-0198

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USDA - RHS
Title of Information Document




OMB No.









0575-0198
SUMMARY OF INFORMATION COLLECTION
7 CFR 3570 Technical Assistance Programs




Date Prepared










Apr-19
INSTRUCTIONS:

> (f) TOTAL
(h) TOTAL

Use this form when a single information collection document involves multiple reporting and


> - = (e) Average - = (g) Average - = (j) Average
recordkeeping requirements.


> (d) TOTAL
(f) TOTAL
(i) TOTAL
IDENTIFICATION OF REPORTING AND RECORDKEEPPING REQUIREMENTS




ANNUAL BURDEN





FORM

REPORTS


RECORDS


NO(s) NO. OF NO. OF TOTAL HOURS TOTAL NO. OF ANNUAL TOTAL
SECTION OF
(If "none" RESPON- RESPONSES ANNUAL PER HOURS RECORD- HOURS PER RECORD-
REGULATIONS DESCRIPTION so state) DENTS PER RESPONSES RESPONSE (Col. f & g) KEEPERS RECORD- KEEPING




RESPON- (Col. d & e)


KEEPER HOURS




DENT




(Col. i & j)
(a) (b) (c) (d) (e) (f) (g) (h) (i) (j) (k)

Reporting Requirements - Non Forms








3570.265(c)(6) Documentation of assistance provided to Rural Development employees Written 42 1 42 0.25 10.00












3570.265(c)(9) Indirect Cost Agreement Written 42 1 42 1.00 42.00













3570.265(c)(10) Statement of Compliance , Title VI of Civil Rights Act of 1964 Written 42 1 42 0.50 21.00













3570.265(d)(1)(i) Evidence of Legal Existence and Authority Written 42 1 42 0.25 10.00













3570.265(d)(1)(ii) Evidence of Tax Exempt Status Written 42 1 42 0.25 10.50













3570.265(d)(2) Narrative - Project Proposal Written 42 1 42 1.00 42.00











3570.265(d)(3) Latest Financial Information Written 42 1 42 1.00 42.00













3570.265(d)(4) Documentation of cash matching funds Written 42 1 42 0.50 21.00













3570.265(d)(5) Scope of Work/Work Plan Written 42 1 42 2.00 84.00













3570.265(d)(7) Budget justification Written 42 1 42 5.00 210.00













3570.265(d)(8) Evidence of Financial Management System Written 42 1 42 0.25 10.50













3570.265(d)(9) Documentation on each of the priority ranking criteria Written 42 1 42 10.00 420.00



Subtotal


504
923.00














Awardees








1775.2 Project Performance Report Written 15 4 60 12.00 720.00













1775.21 Audit Written 15 1 15 3.00 45.00













1775.21 Financial Statements Written 15 1 15 1.00 15.00



Subtotal


90
780.00














Reporting Requirements - Forms



















3570.272( e ) Community Facilities Technical Assistance and Training Grant Agreement RD 3570-4 (0575-0198) 15 1 15 2.00 30.00






































































































Subtotal


15
30.00



Grand Total


609
1,733.00












Common Forms Approved Under Other Packages - Burden Reported as RCF
3570.265(c)(1) Application for Federal Assistance (Non-construction Programs) SF-424 (4040-0004) 42 1 42 1.00 42.00












3570.265(c)(2) Budget Information--Non-Construction Programs SF-424A (4040-0006) 42 1 42 1.00 42.00













3570.265(c)(2) Assurances--Non-construction Programs SF-424B (4040-0007) 42 1 42 0.50 21.00











3570.268(a) Request for Advance or Reimbursement SF-270 (4040-0012) 12 12 144 1.00 144.00













3570.265(c)(11) Disclosure of Lobbying Activities SF LLL (4040-0013) 42 1 42 1.00 42.00













3570.270(a) Federal Financial Report SF-425 (4040-0014) 12 12 144 1.00 144.00


3570.265(c)(7) Equal Opportunity Agreement RD 400-1 (0575-0018) 42 1 42 0.17 7.14


3570.265(c)(8) Assurance Agreement RD 400-4 (0575-0018) 42 1 42 0.25 10.50





































































































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