SF-424B Assurances -- Non-construction Programs 4040-0007

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 4040-0007 4040-0007 Assurances - Non-Construction Programs	Form and Instruction	Modified	Available
Form 4040-0007 SF-424B	Form	Removed	Available
Form 4040-0007 SF-424B	Form	Removed	Available
Form 4040-0007 SF-424B	Form	Removed	Available
Form 4040-0007 SF-424B	Form	Removed	Available
Form 4040-0007 SF-424B	Form	Removed	Repair queued
Form 4040-0007 SF-424B	Form	Removed	Available
Form 4040-0007 SF-424B	Form	Removed	Available
Form 4040-0007 SF-424B	Form	Removed	Available
Form 4040-0007 SF-424B	Form	Removed	Available
Form 4040-0007 SF-424B	Form	Removed	Available
Form 4040-0007 SF-424B	Form	Removed	Repair queued
Form 4040-0007 SF-424B	Form	Removed	Available
Form 4040-0007 SF-424B	Form	Removed	Available
Form 4040-0007 SF-424B	Form	Removed	Available
Form 4040-0007 SF-424B	Form	Removed	Available
Form 4040-0007 SF-424B	Form and Instruction	Removed	Available
OMB comments on Grants.gov Standard forms - GrantsGov Response v2.xlsx	Supplementary Document	Uploaded 2016-01-14	Available
4040-0007 SF-424_B_SS_FINAL_2015 v1.4.docx	Supporting Statement A	Uploaded 2016-01-14	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
196683	HHS burden for SF-424B Assurances -- Non-construction Programs	Form and Instruction	Modified	4040-0007 Assurances - Non-Construction Programs
196682	VA burden for SF-424B Assurances -- Non-construction Programs	Form	Removed	SF-424B
196681	USDOJ burden for SF-424B Assurances -- Non-construction Programs	Form	Removed	SF-424B
196680	USDA burden for SF-424B Assurances -- Non-construction Programs	Form	Removed	SF-424B
196679	USAID burden for SF-424B Assurances -- Non-construction Programs	Form	Removed	SF-424B
196678	Treasury burden for SF-424B Assurances -- Non-construction Programs	Form	Removed	SF-424B
196677	SSA burden for SF-424B Assurances -- Non-construction Programs	Form	Removed	SF-424B
196676	SBA burden for SF-424B Assurances -- Non-construction Programs	Form	Removed	SF-424B
196675	NRC burden for SF-424B Assurances -- Non-construction Programs	Form	Removed	SF-424B
196674	NIST burden for SF-424B Assurances -- Non-construction Programs	Form	Removed	SF-424B
196673	EPA burden for SF-424B Assurances -- Non-construction Programs	Form	Removed	SF-424B
196672	DOT burden for SF-424B Assurances -- Non-construction Programs		Removed
196671	DOL burden for SF-424B Assurances -- Non-construction Programs	Form	Removed	SF-424B
196670	DOI burden for SF-424B Assurances -- Non-construction Programs	Form	Removed	SF-424B
196669	DOD burden for SF-424B Assurances -- Non-construction Programs	Form	Removed	SF-424B
196668	DHS burden for SF-424B Assurances -- Non-construction Programs	Form	Removed	SF-424B
196667	Commerce burden for SF-424B Assurances -- Non-construction Programs	Form	Removed	SF-424B
196666	CNCS burden for SF-424B Assurances -- Non-construction Programs	Form and Instruction	Removed	SF-424B

ICR Details

OMB Control No: 4040-0007	ICR Reference No: 201509-4040-001
Status: Historical Active	Previous ICR Reference No: 201103-4040-002
Agency/Subagency: EGOV	Agency Tracking No:
Title: SF-424B Assurances -- Non-construction Programs 4040-0007
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
Retrieve Notice of Action (NOA)	Date Received in OIRA: 09/29/2015
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2019	36 Months From Approved	06/30/2014
Responses	40,000	0	33,839
Time Burden (Hours)	20,000	0	16,925
Cost Burden (Dollars)	0	0	0

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Abstract: Applicants use the SF-424B to provide information on required assurances when applying for Federal financial assistance under non-construction grant programs. This is a common form.

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

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 65966	11/11/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 7596	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

table that charts list of burden

IC Title	Form No.	Form Name
CNCS burden for SF-424B Assurances -- Non-construction Programs	4040-0007	SF-424B
Commerce burden for SF-424B Assurances -- Non-construction Programs	4040-0007	SF-424B
DHS burden for SF-424B Assurances -- Non-construction Programs	4040-0007	SF-424B
DOD burden for SF-424B Assurances -- Non-construction Programs	4040-0007	SF-424B
DOI burden for SF-424B Assurances -- Non-construction Programs	4040-0007	SF-424B
DOL burden for SF-424B Assurances -- Non-construction Programs	4040-0007	SF-424B
DOT burden for SF-424B Assurances -- Non-construction Programs
EPA burden for SF-424B Assurances -- Non-construction Programs	4040-0007	SF-424B
HHS burden for SF-424B Assurances -- Non-construction Programs	4040-0007	4040-0007 Assurances - Non-Construction Programs
NIST burden for SF-424B Assurances -- Non-construction Programs	4040-0007	SF-424B
NRC burden for SF-424B Assurances -- Non-construction Programs	4040-0007	SF-424B
SBA burden for SF-424B Assurances -- Non-construction Programs	4040-0007	SF-424B
SSA burden for SF-424B Assurances -- Non-construction Programs	4040-0007	SF-424B
Treasury burden for SF-424B Assurances -- Non-construction Programs	4040-0007	SF-424B
USAID burden for SF-424B Assurances -- Non-construction Programs	4040-0007	SF-424B
USDA burden for SF-424B Assurances -- Non-construction Programs	4040-0007	SF-424B
USDOJ burden for SF-424B Assurances -- Non-construction Programs	4040-0007	SF-424B
VA burden for SF-424B Assurances -- Non-construction Programs	4040-0007	SF-424B

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ICR Summary of Burden

table that charts list 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	40,000	33,839	0	-6,521	0	12,682
Annual Time Burden (Hours)	20,000	16,925	0	-3,266	0	6,341
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: The SF-424B Assurances for non-Construction 4040-0007 is now classified as a Common Form. Reported burden is for HHS only. Other Federal agencies are responsible for request of use for IC and reporting of burden hours.

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Annual Cost to Federal Government: $519,999

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:  This form is used by all Federal agencies. Burden reported in this ICR is reported for HHS only. All Federal agencies are required to report their own burden hours for this IC.

Approved RCFs using this ICR

table that charts list of RCF

Agency/Sub Agency	RCF ID	RCF Title	RCF Status	IC Title
DOW/DODDEP	201802-0704-003CF	SF-424B Assurances -- Non-construction Programs 4040-007	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs
DOI/BLM	201606-1004-006CF	BLM - 424B, Assurances for Non-Construction Common Form Usage	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs, HHS burden for SF-424B Assurances -- Non-construction Programs
USDA/APHIS	201702-0579-013CF	Assurances for Non-construction Program (4040-0007)	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs, HHS burden for SF-424B Assurances -- Non-construction Programs
DOI/OSMRE	201605-1029-003CF	Request to use 424B - Assurances for Non-Construction form for OSMRE	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs
USDA/AMS	201610-0581-014CF	SF 424B - Assurances Non-Construction Programs	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs, HHS burden for SF-424B Assurances -- Non-construction Programs, HHS burden for SF-424B Assurances -- Non-construction Programs, HHS burden for SF-424B Assurances -- Non-construction Programs, HHS burden for SF-424B Assurances -- Non-construction Programs
USDA/RHS	201702-0575-018CF	SF-424B Assurances - Non Construction Programs	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs
DOI/NPS	201609-1024-006CF	SF-424B - Assurances for Non-Construction common form usage for NPS.	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs
DOL/DM	201611-1225-011CF	SF-424B Assurances -- Non-construction Programs 4040-0007	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs
USDA/RBS	201612-0570-022CF	Assurances - Non-Construction Programs - SF-424B	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs
USDA/RHS	201607-0575-009CF	SF-424B Assurances - Non Construction Programs	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs, HHS burden for SF-424B Assurances -- Non-construction Programs
USDA/RBS	201612-0570-017CF	SF - 424B Assurances - Non-Construction Programs	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs, HHS burden for SF-424B Assurances -- Non-construction Programs
USDA/RUS	201701-0572-019CF	Assurances - Non-Construction Programs SF424B	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs
USDA/RBS	201605-0570-010CF	SF-424B - Assurances for Non Construction Programs	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs
USDA/RUS	201701-0572-022CF	Assurances - Non-Construction Programs SF-424B	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs
USDA/FNS	201706-0584-014CF	SF-424B Assurances for Non-Construction Programs (FNS)	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs, HHS burden for SF-424B Assurances -- Non-construction Programs
USDA/APHIS	201704-0579-025CF	Non-Construction Program	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs
DOC/NTIA	201709-0660-010CF	Assurances for Non-Construction Programs (SF-424B) for 911 Grant Program	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs
USDA/RUS	201707-0572-027CF	SF-424B - Assurances Non-construction Programs	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs, HHS burden for SF-424B Assurances -- Non-construction Programs, HHS burden for SF-424B Assurances -- Non-construction Programs
USDA/RUS	201710-0572-034CF	Assurances - Non-construction Programs	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs
DOT/FMCSA	201809-2126-004CF	SF-424B Assurances Non-Construction Programs	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs
DOI/FWS	201807-1018-008CF	SF-424B - Assurances for Non-Construction common form usage for USFWS	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs
USDA/FS	201802-0596-011CF	Assurances for Non-Construction Programs (SF-424B)	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs
USDA/RBS	201802-0570-040CF	SF-424B, Assurances - Non-Construction Programs	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs
DOI/GS	201807-1028-001CF	SF-424B - Assurances for Non-Construction common form usage for USGS	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs
DOI/OSMRE	201807-1029-001CF	SF-424B - Assurances for Non-Construction common form usage for OSMRE	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs
DOI/OS	201807-1093-001CF	SF-424B - Assurances for Non-Construction common form usage for OS/PMB	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs
DOI/NPS	201807-1024-001CF	SF-424B - Assurances for Non-Construction common form usage for NPS	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs
USDA/RHS	201810-0575-003CF	SF-424B Assurances – Nonconstruction Programs	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs
DOI/RB	201807-1006-001CF	SF-424B - Assurances for Non-Construction common form usage for BOR	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs
DOI/ONRR	201807-1012-001CF	SF-424B - Assurances for Non-Construction common form usage for ONRR	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs
DOI/BLM	201807-1004-001CF	SF-424B - Assurances for Non-Construction common form usage for BLM	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs
USDA/RUS	201804-0572-044CF	Assurances Non-Construction Programs, SF-424B	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs, HHS burden for SF-424B Assurances -- Non-construction Programs
TREAS/DO	201811-1505-002CF	Social Impact Partnerships to Pay for Results Act (SIPPRA) grant program.	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs
USDA/APHIS	201807-0579-031CF	Assurances - Non-constructions programs	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs
USDA/RHS	201804-0575-026CF	SF-424B Assurances -- Non-Construction Programs	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs
DOI/ONRR	201604-1012-004CF	Request to use 424B - Assurance for Non-Construction form for ONRR.	Historical Active	HHS burden for SF-424B Assurances -- Non-construction Programs

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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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