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State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments
Federal and Non-Federal Financial Assistance Instruments
OMB: 0596-0217
IC ID: 185951
OMB.report
USDA/FS
OMB 0596-0217
ICR 202210-0596-001
IC 185951
( )
Documents and Forms
Document Name
Document Type
Form FS-1500-22
State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments
Form and Instruction
FS-1500-22 Financial Capability Questionaire
FS 1500-22 Financial Capability Questionaire 2.0_v1.docx
Form and Instruction
FS-1500-22b Financial Capability Checklist for State Government Agen
FS-1500-22b Financial Capability Checklist for State Government Agencies_v1.docx
Form
FS-1500-34 Grant Equipment Justification and Certification Statemen
FS-1500-34 Grant Equipment Justification and Certification Statement_v1.docx
Form
FS-1500-35 Certification Regarding Lobbying
FS-1500-35 Certification Regarding Lobbying_v1.docx
Form
FS-1500-22A Financial Capability Checklist
FS-1500-22a Financial Capability Checklist_v1.docx
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
State, Local, and Tribal Govt. - Federal and Non-Federal Financial Assistance Instruments
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
FS-1500-22
Financial Capability Questionaire
FS 1500-22 Financial Capability Questionaire 2.0_v1.docx
Yes
Yes
Fillable Printable
Form
FS-1500-22b
Financial Capability Checklist for State Government Agencies Only
FS-1500-22b Financial Capability Checklist for State Government Agencies_v1.docx
Yes
Yes
Fillable Printable
Form
FS-1500-34
Grant Equipment Justification and Certification Statement
FS-1500-34 Grant Equipment Justification and Certification Statement_v1.docx
Yes
Yes
Fillable Printable
Form
FS-1500-35
Certification Regarding Lobbying
FS-1500-35 Certification Regarding Lobbying_v1.docx
Yes
Yes
Paper Only
Form
FS-1500-22A
Financial Capability Checklist
FS-1500-22a Financial Capability Checklist_v1.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Government
Subfunction:
Central Fiscal Operations
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
1,143
Number of Respondents for Small Entity:
404
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
0 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,143
0
-861
0
0
2,004
Annual IC Time Burden (Hours)
558
0
-16,837
0
0
17,395
Annual IC Cost Burden (Dollars)
0
0
0
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.