Advanced Technology Vehicles Manufacturing Incentive Program

This form is available electronically.
U.S. Department of Energy Reporting and Recordkeeping Requirements						1. OMB No.				2. Title of Clearance		Advanced Technology Vehicles Manufacturing Incentive Program Page 1
3.	4.	5.	6.	7.	Annual Burden on the Public (Col. 8 x 9=10 and Col. 10 x 11=12)
Description (Title of Form, Report or Record)	Report	Record	Form No.	Regulation Part/Sec.	8.		9.		10.		11.		12. Total Burden Hours
					No. of Respondents		No. of Reports Filed Per Person		Total Annual Responses (/1)		Average Time to Respond		Exempt
Certification of Meeting Program Requirements				611	25		1		25		100.00			2500.00
Project Description-Overview				611	25		1		25		20.00		n/a	500.00
Project Eligibility				611	25		1		25		100.00		n/a	2500.00
Cost				611	25		1		25		50.00		n/a	1250.00
Financial Plan				611	25		3*		75		50.00		n/a	3750.00
(sources and uses of funding, equity, and debt)				611	-		-		-				n/a
(liability(ies) of associated parties)				611	-		-		-				n/a
Business Plan				611	25		3*		75		100.00		n/a	7500.00
(pro forma statements)				611	-		-		-
Market Analysis				611	25		1		25		40.00		n/a	1000.00
Financial Statements				611	25		3*		75		100.00		n/a	7500.00
Status of Approval/Permits and Approvals				611	25		4*		100		20.00		n/a	2000.00
Environmental Report				611	25		1		25		50.00		n/a	1250.00
Collateral				611	25		1		25		40.00		n/a	1000.00
Financial Viability Analysis				611	25		1		25		100.00		n/a	2500.00
Laborer and Mechanic Wage Assurances				611	25		1		25		16.00		n/a	400.00

This form is available electronically.
U.S. Department of Energy Reporting and Recordkeeping Requirements						1. OMB No.				2. Title of Clearance		Advanced Technology Vehicles Manufacturing Incentive Program Page 2
3.	4.	5.	6.	7.	Annual Burden on the Public (Col. 8 x 9=10 and Col. 10 x 11=12)
Description (Title of Form, Report or Record)	Report	Record	Form No.	Regulation Part/Sec.	8.		9.		10.		11.		12. Total Burden Hours
					No. of Respondents		No. of Reports Filed Per Person		Total Annual Responses (/1)		Average Time to Respond		Exempt
SF-LLL Form				611	25		1		25		.50		n/a		12.50
Other Information				611	25		1		25		100.00		n/a		2500.00
													n/a
SUBTOTALS=							1*						n/a		1446.5
TOTALS=					25		1		25				n/a		36162.50
* single applications are permitted to contain multiple projects
Projects. Therefore a single application may require
Preparation of multiple business plans, etc