SF-424 Discretionary

Forms and Documents

Document Name	Status
Form SF-424 DOC SF-424 Burden Collection Form	Removed
Form SF-424 DHS SF-424 Burden Collection Form	Removed
Form SF-424 DOJ SF-424 Burden Collection Form	Removed
Form SF-424 DOL SF-424 Burden Collection Form	Removed
Form SF-424 DOD SF-424 Burden Collection Form	Removed
Form SF-424 DOI SF-424 Burden Collection Form	Removed
Form SF-424 USDA SF-424 Burden Collection Form	Removed
Form SF-424 USAID SF-424 Burden Collection Form	Removed
Form SF-424 SSA SF-424 Burden Collection Form	Removed
Form SF-424 HHS SF-424 Burden Collection Form	Modified
Form SF-424 EPA SF-424 Burden Collection Form	Removed
Form SF-424 ED SF-424 Burden Collection Form	Removed
Form SF-424 DOE SF-424 Burden Collection Form	Removed
4040-0004-SF_424_SupportingStatement_2013.doc Supporting Statement A	2013-07-22

IC Document Collections

IC ID	Document Title	Status
35965	DOC SF-424 Burden Collection Form	Removed
189734	DHS SF-424 Burden Collection Form	Removed
189733	DOJ SF-424 Burden Collection Form	Removed
187908	DOL SF-424 Burden Collection Form	Removed
187907	DOD SF-424 Burden Collection Form	Removed
187906	DOI SF-424 Burden Collection Form	Removed
187905	USDA SF-424 Burden Collection Form	Removed
187904	USAID SF-424 Burden Collection Form	Removed
187903	SSA SF-424 Burden Collection Form	Removed
187902	HHS SF-424 Burden Collection Form	Modified
187901	EPA SF-424 Burden Collection Form	Removed
187900	ED SF-424 Burden Collection Form	Removed
187899	DOE SF-424 Burden Collection Form	Removed

ICR Details

OMB Control No: 4040-0004	ICR Reference No: 201307-4040-005
Status: Historical Active	Previous ICR Reference No: 200906-4040-004
Agency/Subagency: EGOV	Agency Tracking No: 16500
Title: SF-424 Discretionary
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  Yes
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/22/2013
	Date Received in OIRA: 07/22/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2016	36 Months From Approved
Responses	14,747	0	0
Time Burden (Hours)	14,747	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The SF-424 was established as the government-wide standard core data set and form for grant applications in July 31, 2003 [Federal Register Notice 68 FR 44974]. Use of the standard data elements was implemented through the electronic grants application process of Grants.gov, and was deployed in October 2003 as part of the implementation of the Federal Financial Assistance Management Improvement Act of 1999 (P.L. 106-107).

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Authorizing Statute(s): PL: Pub.L. 106 - 107 468 Name of Law: Federal Financial Assistance management Improvement Act of 1999
   PL: Pub.L. 109 - 282 2590 Name of Law: Federal Funding Accountability and Transparency Act of 2006
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 14550	03/06/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 42951	07/18/2013
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
DOI SF-424 Burden Collection	SF-424	placeholder
DOD SF-424 Burden Collection	SF-424	placeholder
DOC SF-424 Burden Collection	SF-424	placeholder
DOE SF-424 Burden Collection	SF-424	placeholder
ED SF-424 Burden Collection	SF-424	placeholder
EPA SF-424 Burden Collection	SF-424	placeholder
HHS SF-424 Burden Collection	SF-424	Application for Federal Assistance
SSA SF-424 Burden Collection	SF-424	placeholder
USAID SF-424 Burden Collection	SF-424	placeholder
USDA SF-424 Burden Collection	SF-424	placeholder
DOL SF-424 Burden Collection	SF-424	placeholder
DOJ SF-424 Burden Collection	SF-424	placeholder
DHS SF-424 Burden Collection	SF-424	placeholder

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	14,747	0	0	-342,377	0	357,124
Annual Time Burden (Hours)	14,747	0	0	-376,698	0	391,445
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: This is a request for reinstatement of a previously-approved collection, which expired on March 31, 2012, with a three-year clearance. No program changes or revisions have been implemented with this IC. The request is to change the the form to be a common form, thus reducing the burden estimate to reflect the use of this form by HHS only.

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Annual Cost to Federal Government: $630,582

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Yes

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Yes

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  Yes

OIRA authorizes any Agency to begin using a Common Form associated with this ICR automatically after 5 calendar days from the date the agency's RCF including the common form was received in OIRA.

Description/Changes for Common Form Usage:  This request changes the form to be a common form. The burden estimated thus only reflects the use of this form by HHS.

Approved RCFs using this ICR

Agency/Sub Agency	RCF ID	RCF Title	RCF Status	IC Title
USDA/APHIS	201309-0579-001CF	Application Form for Federal Assistance (SF 424)	Historical Active	USDA SF-424 Burden Collection
USDA/RBS	201505-0570-005CF	SF-424 Discretionary	Historical Active	USDA SF-424 Burden Collection , USDA SF-424 Burden Collection
USDA/AMS	201504-0581-006CF	SF-424 Discretionary	Historical Active	USDA SF-424 Burden Collection
DOL/DM	201309-1225-002CF	Application for Federal Assistance	Historical Active	DOL SF-424 Burden Collection, DOL SF-424 Burden Collection
USDA/AMS	201309-0581-005CF	Application for Federal Assistance	Historical Active	USDA SF-424 Burden Collection
DOL/DM	201309-1225-003CF	Application for Federal Assistance	Historical Active	DOL SF-424 Burden Collection, DOL SF-424 Burden Collection
DOJ/DOJADM	201404-1103-001CF	SF-424 Use For COPS Application Package	Historical Active	DOJ SF-424 Burden Collection
USDA/NIFA	201404-0524-051CF	Budget Information	Historical Active	USDA SF-424 Burden Collection
EPA/OMS	201406-2030-002CF	SF-424 Application for Federal Assistance	Historical Active	EPA SF-424 Burden Collection
USDA/FNS	201502-0584-002CF	SF-424 Application for Federal Assistance (FNS)	Historical Active	USDA SF-424 Burden Collection
USDA/RUS	201310-0572-001CF	SF-424 - Discretionary	Historical Active	USDA SF-424 Burden Collection
DOT/FRA	201511-2130-010CF	Grant Awards and Cooperative Agreements	Historical Active	DOC SF-424 Burden Collection
USDA/AMS	201602-0581-008CF	SF-424-Discretionary-- Application for Federal Assistance	Historical Active	USDA SF-424 Burden Collection
USDA/RHS	201605-0575-005CF	SF-424 - Discretionary - Application for Federal Assistance	Historical Active	USDA SF-424 Burden Collection
DOI/NPS	201609-1024-004CF	SF-424 Discretionary Grant form usage for NPS	Historical Active	HHS SF-424 Burden Collection
TREAS/IRS	201610-1545-001CF	SF-424: IRS Use of Application for Federal Assistance Form	Historical Active	HHS SF-424 Burden Collection

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 07/22/2013

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