Request for Common Form Usage

Forms and Documents

Document	Type	Status	Availability
Form 4040-0001 5 Year R&R Subaward Budget (Fed/Non-Fed) Form 30 Attachments	Form	New	Available
Form 4040-0001 5 Year R&R Subaward Budget Attachment(s) Form (up to 30 attachments)	Form	New	Available
Form 4040-0001 R&R Federal/Non-Federal Budget (up to 5 years)	Form	New	Available
Form 4040-0001 SBIR/STTR Information	Form	New	Available
Form 4040-0001 SF 424 Application for Federal Assistance Research and Related Cover	Form	New	Available
Form 4040-0001 R&R Personal Data	Form	New	Available
Form 4040-0001 5 Year R&R Subaward Budget Attachment(s) Form (up to 30 attachments)	Form	New	Available
Form 4040-0001 R&R Budget (up to 5 years)	Form	New	Available
Form 4040-0001 R&R Other Project Information	Form	New	Available
Form 4040-0001 R&R Senior/Key Person Profile (Expanded)	Form	New	Available

IC Document Collections

IC ID	Collection	Type	Status	Form
225468	5 Year R&R Subaward Budget (Fed/Non-Fed) Form 30 Attachments	Form	New
225467	5 Year R&R Subaward Budget Attachment(s) Form (up to 30 attachments)	Form	New
225466	R&R Federal/Non-Federal Budget (up to 5 years)	Form	New
225464	SBIR/STTR Information	Form	New
225460	SF 424 Application for Federal Assistance Research and Related Cover	Form	New
225456	R&R Personal Data	Form	New
225454	5 Year R&R Subaward Budget Attachment(s) Form (up to 30 attachments)	Form	New
225451	R&R Budget (up to 5 years)	Form	New
225450	R&R Other Project Information	Form	New
225448	R&R Senior/Key Person Profile (Expanded)	Form	New

ICR Details

OMB Control No: 4040-0001	ICR Reference No: 201701-0524-063CF
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: USDA/NIFA	Agency Tracking No:
Title: Request for Common Form Usage
Type of Information Collection: RCF New	Common Form ICR:
Type of Review Request:
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/07/2017
	Date Received in OIRA: 02/01/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2019
Responses	34,376	0	0
Time Burden (Hours)	34,376	0	0
Cost Burden (Dollars)	0	0	0

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Abstract:

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR?

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Number of Information Collection (IC) in this ICR: 10

IC Title	Form No.	Form Name
R&R Other Project Information	4040-0001	Research & Related Other Project Information
R&R Budget (up to 5 years)	4040-0001	Research & Related Budget
5 Year R&R Subaward Budget Attachment(s) Form (up to 30 attachments)	4040-0001	5 Year R&R Subaward Budget(Fed/Non-Fed) Attachments 30 Attachments
R&R Personal Data	4040-0001	Research and Related Personal Data
SF 424 Application for Federal Assistance Research and Related Cover	4040-0001	SF424 Application for Federal Assistance Research and Related Cover
SBIR/STTR Information	4040-0001	SBIR/STTR Form
R&R Federal/Non-Federal Budget (up to 5 years)	4040-0001	Research and Related Budget (Total Fed + Non-Fed)
5 Year R&R Subaward Budget Attachment(s) Form (up to 30 attachments)	4040-0001	5 Year R&R Subaward Budget(Fed/Non-Fed) Attachments 30 Attachments
5 Year R&R Subaward Budget (Fed/Non-Fed) Form 30 Attachments	4040-0001	5 Year R&R Subaward Budget(Fed/Non-Fed) Attachments 30 Attachments
R&R Senior/Key Person Profile (Expanded)	4040-0001	Research & Related Senior/Key Person Profile (Expanded)

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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	34,376	0	0	34,376	0	0
Annual Time Burden (Hours)	34,376	0	0	34,376	0	0
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: No

Burden Reduction Due to:

Short Statement: For common form usage.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods?

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.    

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.    

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

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

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

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR: 

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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:

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