SF-424 Discretionary

Forms and Documents

Document Name	Status
Form SF-424 HHS SF-424 Burden Collection Form	Modified
4040-0004 ICR SS.docx Supporting Statement A	2016-08-31

IC Document Collections

IC ID	Document Title	Status
187902	HHS SF-424 Burden Collection Form	Modified

ICR Details

OMB Control No: 4040-0004	ICR Reference No: 201608-4040-014
Status: Historical Active	Previous ICR Reference No: 201307-4040-005
Agency/Subagency: EGOV	Agency Tracking No: 16500
Title: SF-424 Discretionary
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  Yes
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/01/2016
	Date Received in OIRA: 08/31/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2019	36 Months From Approved	11/30/2016
Responses	14,883	0	14,747
Time Burden (Hours)	14,883	0	14,747
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. 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:
	81 FR 9487	02/25/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 39993	06/20/2016
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
HHS SF-424 Burden Collection	SF-424	Application for Federal Assistance

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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	14,883	14,747	0	0	136	0
Annual Time Burden (Hours)	14,883	14,747	0	0	136	0
Annual Cost Burden (Dollars)	0	0	0	-446,490	446,490	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: No

Burden Reduction Due to:

Short Statement: The form burden increase is due to an increase in the submission volume of the SF424. Change Due to Agency Estimate is due to reporting burden for HHS only.

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Annual Cost to Federal Government: $580,437

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:  The SF424 is used by all Federal grant making agencies. The form is required for the public to apply for federal grants.

Approved RCFs using this ICR

Agency/Sub Agency	RCF ID	RCF Title	RCF Status	IC Title
USDA/RBS	201701-0570-030CF	Application for Federal Assistance - SF 424	Historical Active	HHS SF-424 Burden Collection
USDA/RHS	201702-0575-016CF	SF-424 Application for Federal Assistance	Historical Active	HHS SF-424 Burden Collection , HHS SF-424 Burden Collection
USDA/RBS	201701-0570-025CF	Application for Federal Assistance - SF-424 Discretionary	Historical Active	HHS SF-424 Burden Collection
USDA/RHS	201701-0575-015CF	Application for Federal Assistance SF-424 - Discretionary	Historical Active	HHS SF-424 Burden Collection , HHS SF-424 Burden Collection , HHS SF-424 Burden Collection
USDA/RBS	201612-0570-020CF	Application for Federal Assistance - SF-424	Historical Active	HHS SF-424 Burden Collection
USDA/RHS	201701-0575-014CF	Application for Federal Assistance SF 424 - Discretionary	Historical Active	HHS SF-424 Burden Collection , HHS SF-424 Burden Collection
USDA/RUS	201607-0572-008CF	Application for Federal Assistance SF-424 - Discretionary	Historical Active	HHS SF-424 Burden Collection
USDA/RBS	201612-0570-015CF	SF - 424 Application for Federal Assistance - Discretionary	Historical Active	HHS SF-424 Burden Collection , HHS SF-424 Burden Collection
DOL/DM	201703-1225-014CF	SF-424 Discretionary--DOL Usage	Historical Active	HHS SF-424 Burden Collection
USDA/RUS	201701-0572-013CF	Application for Federal Assistance - SF 424 - Discretionary	Historical Active	HHS SF-424 Burden Collection
DOI/NPS	201612-1024-012CF	SF-424 Discretionary Grant form usage for NPS	Historical Active	HHS SF-424 Burden Collection
USDA/APHIS	201701-0579-007CF	Application for Federal Assistance SF-424-Discretionary	Historical Active	HHS SF-424 Burden Collection , HHS SF-424 Burden Collection
TREAS/IRS	201612-1545-002CF	SF-424: IRS Use of Application for Federal Assistance Form	Historical Active	HHS SF-424 Burden Collection
USDA/RUS	201701-0572-020CF	Application for Federal Assistance - SF-424	Historical Active	HHS SF-424 Burden Collection
USDA/FNS	201706-0584-009CF	SF-424 Application and Instruction for Federal Assistance (FNS)	Historical Active	HHS SF-424 Burden Collection , HHS SF-424 Burden Collection
USDA/APHIS	201704-0579-023CF	Application for Federal Assistance	Historical Active	HHS SF-424 Burden Collection
DOT/FAA	201704-2120-004CF	Aviation Research Grants Program	Historical Active	HHS SF-424 Burden Collection
USDA/RHS	201804-0575-025CF	SF-424 Application for Federal Assistance	Historical Active	HHS SF-424 Burden Collection
USDA/RUS	201709-0572-031CF	SF-424 Federal Assistance Application - Discretionary	Historical Active	HHS SF-424 Burden Collection
DOC/NTIA	201709-0660-008CF	Application for Federal Assistance (SF-424) for the 911 Grant Program	Historical Active	HHS SF-424 Burden Collection
USDA/RUS	201707-0572-025CF	SF-424 Federal Assistance Application - Discrectionary	Historical Active	HHS SF-424 Burden Collection , HHS SF-424 Burden Collection
USDA/RUS	201710-0572-032CF	Application for Federal Assistance	Historical Active	HHS SF-424 Burden Collection
USDA/AMS	201910-0581-005CF	4040-0004 Application for Federal Assistance SF-424	Historical Active	HHS SF-424 Burden Collection
USDA/RHS	201705-0575-022CF	SF - 424 Application for Federal Assistance	Historical Active	HHS SF-424 Burden Collection
USDA/APHIS	201807-0579-028CF	Application for Federal Assistance	Historical Active	HHS SF-424 Burden Collection
USDA/RHS	201806-0575-029CF	SF-424 Application for Federal Assistance	Historical Active	HHS SF-424 Burden Collection
USDA/RUS	201804-0572-041CF	Application for Federal Assistance (SF-424)	Historical Active	HHS SF-424 Burden Collection , HHS SF-424 Burden Collection
DOT/FMCSA	201809-2126-002CF	SF-424 Application for Federal Assistance	Historical Active	HHS SF-424 Burden Collection
USDA/FAS	201907-0551-001CF	Application for Federal Assistance	Historical Active	HHS SF-424 Burden Collection , HHS SF-424 Burden Collection
USDA/RHS	201810-0575-001CF	SF-424 Application for Federal Assistance	Historical Active	HHS SF-424 Burden Collection
USDA/RBS	201904-0570-002CF	SF-424 “Application for Federal Assistance	Historical Active	HHS SF-424 Burden Collection
USDA/RBS	201802-0570-038CF	SF-424, "Application for Federal Assistance"	Historical Active	HHS SF-424 Burden Collection
USDA/RHS	201710-0575-024CF	SF 424 - Application for Federal Assistance	Historical Active	HHS SF-424 Burden Collection
USDA/RBS	201906-0570-007CF	Standard Form 424-2	Historical Active	HHS SF-424 Burden Collection
TREAS/DO	201808-1505-001CF	Social Impact Partnerships to Pay for Results Act (SIPPRA) grant program	Historical Active	HHS SF-424 Burden Collection
USDA/RHS	201806-0575-031CF	SF-424 Application for Federal Assistance	Historical Active	HHS SF-424 Burden Collection
DOI/FWS	201807-1018-005CF	SF-424 Discretionary Grant form usage for USFWS	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: 08/31/2016

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