PHS Supplements to Application for Federal Assistance (SF 424)

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Documents and Forms

Document Name Document Type

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Information Collection (IC) Details

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IC Title:	PHS Supplements to Application for Federal Assistance (SF 424)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	CDC.124(E)	No	No
Form	SF-424	No	No
Form	CDC.0113	No	No
Form	OPHS-1	No	No
Form	PHS-5161-1	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 16,994	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	16,994	5	16,989
Annual IC Time Burden (Hours)	42,711	20	42,691
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.