Statement and Acknowledgment (SF 1413); FAR Sections Affected: 22.406-5; 22.407(a); 52.222-11(b); 53.222(e); 53.301-SF 1413

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 9000-0014 can be found here:

Documents and Forms

Document Name Document Type
Form SF 1413 Statement and Acknowledgment (SF 1413); FAR Sections Affected: 22.406-5; 22.407(a); 52.222-11(b); 53.222(e); 53.301-SF 1413 Form
SF 1413 Statement and Acknowledgment sf1413.pdf www.gsa.gov Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Statement and Acknowledgment (SF 1413); FAR Sections Affected: 22.406-5; 22.407(a); 52.222-11(b); 53.222(e); 53.301-SF 1413	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 48 CFR 22.407(a) 48 CFR 52.222-11(b) 48 CFR 53.222(e) 48 CFR 22.406-5 48 CFR 53.301

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SF 1413	Statement and Acknowledgment	sf1413.pdf	www.gsa.gov	Yes	No	Fillable Fileable

Line of Business: Supply Chain Management

Subfunction: Goods Acquisition

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 31,500	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 99 %

	Approved	Previously Approved
Annual Number of Responses for this IC	63,000	63,000
Annual IC Time Burden (Hours)	3,150	3,150
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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