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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-I: 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.
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TITLE OF INFORMATION COLLECTION DOCUMENT |
OMB NO. |
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| Temporary Bridge Funding Opportunity Program |
0596-NEW |
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| DATE PREPARED |
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| October 5, 2022 |
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| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT |
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ANNUAL BURDEN |
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REPORTS |
RECORDS |
RESPONDENT COST |
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TOTAL |
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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 |
| REGS. |
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so state) |
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PER |
(Col. D x E) |
RESPONSE |
(Col. F x G) |
KEEPERS |
RECORD- |
(Col. I x J) |
HOUR |
(Col. H x L) |
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RESPONDENT |
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KEEPER |
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| (A) |
(B) |
(C) |
(D) |
(E) |
(F) |
(G) |
(H) |
(I) |
(J) |
(K) |
(L) |
(M) |
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Temporary Bridge Funding Application |
FS-1500-48 |
100 |
1.00 |
100.00 |
3.250 |
325.00 |
0 |
0.000 |
0.00 |
40.90 |
$13,292.50 |
|
Certificate Regarding Lobbying Activities |
FS-1500-35 |
100 |
1.00 |
100.00 |
0.250 |
25.00 |
0 |
0.000 |
0.00 |
40.90 |
$1,022.50 |
|
Financial Capability Questionnaire |
FS-1500-22 |
100 |
1.00 |
100.00 |
0.250 |
25.00 |
0 |
0.000 |
0.00 |
40.90 |
$1,022.50 |
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Interim Project Progress Report |
FS-1500-23 |
100 |
4.00 |
400.00 |
0.750 |
300.00 |
0 |
0.000 |
0.00 |
40.90 |
$12,270.00 |
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Screenshot of active SAM.gov registration |
None |
100 |
1.00 |
100.00 |
0.250 |
25.00 |
0 |
0.000 |
0.00 |
40.90 |
$1,022.50 |
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SUBTOTAL |
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800.00 |
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700.00 |
0.00 |
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0.00 |
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$28,630.00 |
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TOTAL OF ALL PAGES |
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800.00 |
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700.00 |
0.00 |
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0.00 |
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$28,630.00 |
| TOTAL - COLUMNS "F" AND "I" = OMB 831, 13 b; COLUMNS "H" AND "K" = OMB 831, 13c |
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800.00 |
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700.00 |
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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-I: 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. |
|
|
|
|
|
|
|
|
|
| Temporary Bridge Funding Opportunity Program |
0596-NEW |
|
|
|
|
|
|
|
|
| DATE PREPARED |
|
|
|
|
|
|
|
| October 5, 2022 |
|
|
|
|
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT |
|
ANNUAL BURDEN |
|
|
|
|
|
|
|
|
|
|
|
|
REPORTS |
RECORDS |
RESPONDENT COST |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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|
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TOTAL |
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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 |
| REGS. |
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|
so state) |
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PER |
(Col. D x E) |
RESPONSE |
(Col. F x G) |
KEEPERS |
RECORD- |
(Col. I x J) |
HOUR |
(Col. H x L) |
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RESPONDENT |
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KEEPER |
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| (A) |
(B) |
(C) |
(D) |
(E) |
(F) |
(G) |
(H) |
(I) |
(J) |
(K) |
(L) |
(M) |
|
Application for Federal Assistance |
SF-424 |
100 |
1.00 |
100.00 |
1.250 |
125.00 |
0 |
0.000 |
0.00 |
40.90 |
$5,112.50 |
|
Budget Information for Non-Construction Programs |
SF-424A |
100 |
1.00 |
100.00 |
1.000 |
100.00 |
0 |
0.000 |
0.00 |
40.90 |
$4,090.00 |
|
Federal Financial Report |
SF-425 |
100 |
1.00 |
100.00 |
0.750 |
75.00 |
0 |
0.000 |
0.00 |
40.90 |
$3,067.50 |
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SUBTOTAL |
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300.00 |
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300.00 |
0.00 |
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0.00 |
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$5,112.50 |
|
TOTAL OF ALL PAGES |
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300.00 |
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300.00 |
0.00 |
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0.00 |
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$5,112.50 |
| TOTAL - COLUMNS "F" AND "I" = OMB 831, 13 b; COLUMNS "H" AND "K" = OMB 831, 13c |
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300.00 |
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300.00 |
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