Information Collection

HHS Burden Estimate for 4040-0010

IC 211153 under ICR 201404-1225-006CF · OMB 4040-0010.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 4040-0010 can be found here:

Documents and Forms

Document Name Document Type
Form 4040-0010 HHS Burden Estimate for 4040-0010 Form
4040-0010 Key Contacts Key_Contacts-V1.0.pdf Form
4040-0010 Project/Performance Site Location PerformanceSite_1_4-V1.4.pdf Form
4040-0010 Project Abstract Project_Abstract-V1.1.pdf Form

Information Collection (IC) Details

View RCF Information Collection (IC)

IC Title:	HHS Burden Estimate for 4040-0010	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	4040-0010	Key Contacts	Key_Contacts-V1.0.pdf	Yes	Yes	Fillable Fileable
Form	4040-0010	Project/Performance Site Location	PerformanceSite_1_4-V1.4.pdf	Yes	Yes	Fillable Fileable
Form	4040-0010	Project Abstract	Project_Abstract-V1.1.pdf	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,600	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,600	2,600
Annual IC Time Burden (Hours)	1,300	1,300
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.