Burden Hours Summary Worksheet

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.
								Rural Community Development Initiative					0575-0180
													DATE PREPARED
													November 20, 2024
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT							ANNUAL BURDEN
							REPORTS					RECORDS			RESPONDENT COST
														TOTAL
						FORMS NO (S)	NO. OF	NO OF	TOTAL ANNUAL	HOURS	TOTAL	NO. OF	ANNUAL	RECORD-	COST	TOTAL
SECTION OF	DESCRIPTION					(If "none"	RESPONDENTS	RESPONSES	RESPONSES	PER	HOURS	RECORD-	HOURS PER	KEEPING HOURS	PER	COST
NOTICE						so state)		PER	(Col. D x E)	RESPONSE	(Col. F x G)	KEEPERS	RECORD-	(Col. I x J)	HOUR	(Col. H x L)
								RESPONDENT					KEEPER
(A)	(B)					(C)	(D)	(E)	(F)	(G)	(H)	(I)	(J)	(K)	(L)	(M)
	Reporting Requirements - Non-Forms Applicants
	Association or Relationship with Rural Development Employees					Written	65	1.00	65.00	0.25	16.25			0.00	$43.41	$705.41
	System for Award Management System (SAM) and Unique Entity Indentifier (UEI)					Written	65	1.00	65.00	0.25	16.25			0.00	$43.41	$705.41
D. 2	Application Narrative					Written	65	1.00	65.00	10.00	650.00			0.00	$43.41	$28,216.50
	Certification of Non-Lobbying Activities					Written	65	1.00	65.00	0.25	16.25			0.00	$43.41	$705.41
	Reporting Requirements - Non-Forms Awardees/Grantees
Grant Amounts	Modification of Application for Reduced Grant Amount					Written	20	1.00	20.00	1.00	20.00			0.00	$43.41	$868.20
	Performance Progresss Report					Written	30	3.00	90.00	1.00	90.00			0.00	$43.41	$3,906.90
	Performance Progresss Report (Final)					Written	30	1.00	30.00	2.00	60.00			0.00	$43.41	$2,604.60
	Financial Reporting					Written	30	3.00	90.00	1.00	90.00			0.00	$43.41	$3,906.90
	Financial Management System					Written	30	3.00	90.00	6.00	540.00			0.00	$43.41	$23,441.40
Contents of Application	Audits (over $750,000)					Written	20	1.00	20.00	3.00	60.00			0.00	$43.41	$2,604.60
	Reporting Requirements – Non-forms - Record Keeping Requirements
	Data Collection by Race, Sex and National Origin -- Intermediaries - 30 -- Recipients & Beneficiaries- 810					Written	840	1.00	840.00	1.00	840.00			0.00	$43.41	$36,464.40
	SUBTOTAL								1,440.00		2,398.75					104,129.74
	Reporting Req. - Form Burden Approved under other OMB Numbers
Contents of Application	Standard Form 424, "Application for Federal Assistance" (Common Form - burden reported under RCF)					SF-424 (4040-0004)	65	1.00	65.00	1.00	65.00			0.00	$43.41	$2,821.65
	Standard Form LLL, “Disclosure of Lobbying Activities"					SF-LLL (4040-0013)	65	1.00	65.00	0.25	16.25			0.00	$43.41	$705.41
Grantee Req.	Standard Form 270, "Request for Advance or Reimbursement"					SF-270 (4040-0012)	30	3.00	90.00	1.00	90.00			0.00	$43.41	$3,906.90
	Standard Form 425, “Federal Financial Rep					SF-425 (4040-0014)	30	3.00	90.00	0.50	45.00			0.00	$43.41	$1,953.45
Required for each recipient D.2.f.	Form RD 400-4, "Assurance Agreement"					RD 400-4	585	1.00	585.00	0.25	146.25			0.00	$43.41	$6,348.71
	Form RD 442-2, "Statement of Budget, Income, and Equity"					RD 442-2	30	3.00	90.00	2.50	225.00			0.00	$43.41	$9,767.25
	Form RD 442-3, "Balance Sheet"					RD 442-3	30	3.00	90.00	1.00	90.00			0.00	$43.41	$3,906.90