Information Collection

HHS SF-424 Burden Collection

IC 228411 under ICR 201709-0660-008CF · OMB 4040-0004.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 4040-0004 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SF-424 HHS SF-424 Burden Collection	Form
SF-424 Application for Federal Assistance SF424_2_1-V2.1.pdf	Form

IC Title:

HHS SF-424 Burden Collection

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 2 CFR 230 2 CFR 215 5 CFR 1320.5(d)(s) 2 CFR 225 2 CFR 220

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SF-424	Application for Federal Assistance	SF424_2_1-V2.1.pdf		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 60

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	60	60
Annual IC Time Burden (Hours)	60	60
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.