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Forms & Certifications
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The information on this webpage is associated with all ARS, ERS and NASS extramural agreements.


Registration in the System for Award Management (SAM) is required for eligibility for a Federal award. Registrations must be updated annually by Federal recipients.

Effective, February 1, 2020, SAM became the central repository for common government-wide certifications and representations required for Federal recipients.  This eliminated the need for Federal recipients to complete forms & certifications for each Federal award. ARS, ERS and NASS will use current SAM certifications and representations to comply with award requirements.

USDA Certifications.  The following USDA certifications are required when Certifications and Representations have not been made in SAM. The links to the forms in the table below will take you to the USDA Electronic Forms page (  At the USDA Electronic Forms page, scroll down to search for the Prefix-Form No, then download the form(s) for completion.
Prefix Form No Subject
AD-1047 Certification Regarding Debarment, Suspension, and Other Responsibility Matters - Primary Covered Transactions
AD-1048 Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions
AD-1049 Certification Regarding Drug-Free Workplace Requirements (Grants) Alternative I - For Grantees Other than Individuals
AD-1050 Certification Regarding Drug-Free Workplace Requirements (Grants) Alternative II - For Grantees Who are Individuals
AD-1052 Certification Regarding Drug-Free Workplace State and State Agencies, Federal Fiscal Year
AD-3030 Representations Regarding Felony Conviction and Tax Delinquent Status for Corporate Applicants


OMB Lobbying Forms  
Prefix Form No Subject
OMB 4040-0013 V1.1

Certification Regarding Lobbying

Every time a potential recipient applies for or receives a grant or cooperative agreement in excess of $100,000, it must file a written certification that states that no Federal funds have been paid for lobbying.

OMB 4040-0013 SF-LLL-V2.0 

Disclosure of Lobbying Activities

Used by applicants and recipients to disclose lobbying activities that have been secured to influence the outcome of a Federal action.




Pre-Award Forms: 



 OMB No.


Project/Performance Site Location(s)– this OMB form provides the Agency “Place of Performance” information.


 Organization Information, Representations, Assurances and Certifications

 AD 3030

 Representations Regarding Felony Conviction and Tax Delinquent Status for Corporate Applicants

 Management and Financial Reports:




RSA Management Report Template - for Research Support Agreements (originally ARS-157). NOTE: The Cooperator may use this template or their own reporting template.


Research Performance Progress Report (RPPR)

- The RPPR has been mandated by the Federal Office of Management and Budget and coordinated by the National Science Foundation. Accomplishments, "how have the results been disseminated to communities of interest," must include information addressing the sharing of publications, including published data.

RPPR Cover Page.wpd

 RPPR Cover Page Data Elements template for Cooperator use for submission of the RPPR.


Federal Financial Report - applicable for all awards.

 - When used by the non-Federal entity for Non-Assistance Cooperative Agreements, refer to 7 CFR part 550, 550.123(a) for financial reporting conditions (“a financial report must contain an itemization of actual dollar amounts expended on the project during the reporting period (in line with the approved budget), and cumulative totals expended for each budget category from the start date of the award.”).





(OMB No. 4040-0012)

SF-270 Request for Advance or Reimbursement




 OMB No.

   4040-0001 Research & Related Budget (Total Fed + Non-Fed)

- Acceptable for use with Non-Assistance Cooperative Agreements

OMB No. 

4040-0001 Research & Related Budget 3.0

- Acceptable for use with Grant Agreements and Cooperative Agreements


Grant and Cooperative Agreement Budget, dated 11/2018.  Previous versions are obsolete.

REE-454 Non-Assistance Cooperative Agreement Budget, dated 11/2018.  Previous versions are obsolete.

 Tangible Personal Property Report:





Report Form and Instructions

(2 pages, 29 kb)





Disposition Request/Report

(2 pages, 27 kb)





Supplemental Form and Instructions

(2 pages, 26 kb)


 Other Documents:




Civil Rights Poster: “AND JUSTICE FOR ALL”

This poster (AD 475C; Sep 2019) is to be prominently displayed in all offices where there is a USDA presence and where it may be read by customers. 

Recipients of federally funded agreements are required to display this poster in their facilities where it can be viewed by customers.

"And Justice for All" posters must be displayed in a specific size: 11" width x 17" height.