SF-424 Short Organizational (Short) 4040-0003

Forms and Documents

Document Name	Status
Form 4040-0003 HHS SF-424 Short Organizational Burden Estimate 4040-0003 Form	Modified
OMB comments on Grants.gov Standard forms - GrantsGov Response v2.xlsx Supplementary Document	2016-01-14
4040-0003 Short_SS_FINAL_2015 v1.5.doc Supporting Statement A	2016-01-14

IC Document Collections

IC ID	Document Title	Status
35963	DOI SF-424 Short Organizational Burden Estimate Instruction	Removed
189732	DHS SF-424 Short Organizational Burden Estimate Instruction	Removed
186778	DOS SF-424 Short Organizational Burden Estimate Instruction	Removed
186777	HHS SF-424 Short Organizational Burden Estimate 4040-0003 Form	Modified
186776	NEH SF-424 Short Organizational Burden Estimate Instruction	Removed
186775	NEA SF-424 Short Organizational Burden Estimate Instruction	Removed

ICR Details

OMB Control No: 4040-0003	ICR Reference No: 201508-4040-009
Status: Historical Active	Previous ICR Reference No: 200907-4040-001
Agency/Subagency: EGOV	Agency Tracking No:
Title: SF-424 Short Organizational (Short) 4040-0003
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR:  Yes
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 01/15/2016
	Date Received in OIRA: 09/29/2015
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2019	36 Months From Approved	11/30/2011
Responses	8,388	0	10,697
Time Burden (Hours)	4,194	0	3,941
Cost Burden (Dollars)	0	0	0

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Abstract: The SF-424 Short Organizational (short) form supports the streamlined application requirements of smaller applicant organizations and reduces the administrative burden on this community.

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Authorizing Statute(s): US Code: 31 USC 6301-6308 Name of Law: The Federal Grant and Cooperative Agreement Act of 1977
  

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:
	79 FR 65965	11/06/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 7597	02/11/2015
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 Short Organizational Burden Estimate	4040-0003, 4040-0003, 4040-0003	SF-424 Short organizational ,   SF-424 Project Abstract ,   SF-424 Key Contacts
DHS SF-424 Short Organizational Burden Estimate	4040-0003, 4040-0003, 4040-0003	SF-424 Short organizational ,   SF-424 Project Abstract ,   SF-424 Key Contacts
DOS SF-424 Short Organizational Burden Estimate	4040-0003, 4040-0003, 4040-0003	SF-424 Short organizational ,   SF-424 Project Abstract ,   SF-424 Key Contacts
NEH SF-424 Short Organizational Burden Estimate	4040-0003, 4040-0003, 4040-0003	SF-424 Key Contacts ,   SF-424 Short organizational ,   SF-424 Project Abstract
NEA SF-424 Short Organizational Burden Estimate	4040-0003, 4040-0003, 4040-0003	SF-424 Short organizational ,   SF-424 Project Abstract ,   SF-424 Key Contacts
HHS SF-424 Short Organizational Burden Estimate 4040-0003	4040-0003	SF-424 Short Organization Form

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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	8,388	10,697	0	-6,212	0	3,903
Annual Time Burden (Hours)	4,194	3,941	0	-1,699	0	1,952
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to: Miscellaneous Actions

Short Statement: This form has been categorized as a common form as it is used by all federal grant-making agencies. HHS owns the form and reports only HHS burden hours. Other federal grant-making agencies must request use of the form and are responsible for reporting burden hours.

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Annual Cost to Federal Government: $163,566

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]? No

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)? No

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:  The SF-424 Short Organizational common form is used by various Federal grant-making agencies. Grants.gov is only responsible for reporting burden on behalf of HHS. All other agencies must request to use the IC and report their burden hours in ROCIS

Approved RCFs using this ICR

Agency/Sub Agency	RCF ID	RCF Title	RCF Status	IC Title

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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: 09/29/2015

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