Tangible Personal Property Report; Standard Forms 428, 428(a), 428(b), 428(C), and 428(S)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form SF-428-A Tangible Personal Property Report, Standard Forms 428, 428(a), 428(b) and 428(c)	Form and Instruction	Modified	Repair queued
4040-0018 SF-428__Tangible_SS_v1.0.docx	Supporting Statement A	Uploaded 2017-06-13	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
192059	Tangible Personal Property Report, Standard Forms 428, 428(a), 428(b) and 428(c)	Form and Instruction	Modified

ICR Details

OMB Control No: 4040-0018	ICR Reference No: 201701-4040-001
Status: Active	Previous ICR Reference No: 201605-4040-001
Agency/Subagency: EGOV	Agency Tracking No:
Title: Tangible Personal Property Report; Standard Forms 428, 428(a), 428(b), 428(C), and 428(S)
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 without change	Conclusion Date: 06/15/2017
	Date Received in OIRA: 06/14/2017
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2020	36 Months From Approved
Responses	2,000	0	0
Time Burden (Hours)	2,000	0	0
Cost Burden (Dollars)	60,000	0	0

---

Abstract: The Tangible Personal Property Report (SF-428) is a standard form designed to assist recipients when they are required to provide a Federal agency with information related to federally owned property, or equipment and supplies (tangible personal property) acquired with federal assistance award funds. The information collected is used by the awarding agencies to determine appropriate disposition for federally owned property and equipment and supplies acquired with grant funds when the federal government has retained an interest in the property. For example, upon completion of an award, a recipient must report federally owned property to the awarding agency for further agency reutilization.

---

Authorizing Statute(s): PL: Pub.L. 109 - 282 2590 Name of Law: Federal Financial 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

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 6583	01/19/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 15525	03/29/2017
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Tangible Personal Property Report, Standard Forms 428, 428(a), 428(b) and 428(c)	SF-428, SF-428-A, SF 428-B, SF-428-C	Standard Form 428, Annual Report and Instructions-A ,   Standard Form 428-C- Disposition Request Form and Instructions-C ,   Tangible Personal Property Report and Instructions ,   Standard Form 428-B- Final Report and Instructions-B

---

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	2,000	0	0	-14,777	0	16,777
Annual Time Burden (Hours)	2,000	0	0	-31,347	0	33,347
Annual Cost Burden (Dollars)	60,000	0	0	60,000	0	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: As the IC shall be classified as a common form, HHS is only responsible for reporting the agency's burden hours. Other Federal agencies are required to provide their burden hours if they choose to use the SF-428 Tangible Personal Property Report.

---

Annual Cost to Federal Government: $78,000

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

---

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 form will be classified as a common form as it will be used by more than one agency.

Approved RCFs using this ICR

table that charts list of RCF

Agency/Sub Agency	RCF ID	RCF Title	RCF Status	IC Title
USDA/FS	201802-0596-014CF	Tangible Personal Property Report and Instructions (SF-428, 428A, 428B, 428C, 428S)	Active	Tangible Personal Property Report, Standard Forms 428, 428(a), 428(b) and 428(c)
USDA/AMS	201910-0581-003CF	Tangible Personal Property Final Report::	Active	Tangible Personal Property Report, Standard Forms 428, 428(a), 428(b) and 428(c)
DOT/FAA	202004-2120-011CF	FAA Aircraft Pilots Workforce Development Grant Program - Tangible Property Forms Request	Active	Tangible Personal Property Report, Standard Forms 428, 428(a), 428(b) and 428(c), Tangible Personal Property Report, Standard Forms 428, 428(a), 428(b) and 428(c)
DOT/FAA	202004-2120-020CF	FAA Aviation Maintenance Technical Workers Workforce Development Grant Program - Tangible Property Forms Request	Active	Tangible Personal Property Report, Standard Forms 428, 428(a), 428(b) and 428(c), Tangible Personal Property Report, Standard Forms 428, 428(a), 428(b) and 428(c)

---

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: 06/14/2017

---