Request for Common Form Usage

Forms and Documents

Document Name	Status
Form 4040-0001 R&R Personal Data Form	New
Form 4040-0001 5 Year R&R Subaward Budget (Fed/Non-Fed) Form 10 Attachments Form	Unchanged
Form 4040-0001 R&R Federal/Non-Federal Budget (up to 5 years) Form	Unchanged
Form 4040-0001 R&R Other Project Information Form	Unchanged
Form 4040-0001 R&R Senior/Key Person Profile (Expanded) Form	Unchanged
Form 4040-0001 SF 424 Application for Federal Assistance Research and Related Cover Form	Unchanged

IC Document Collections

IC ID	Document Title	Status
230706	R&R Personal Data Form	New
225595	5 Year R&R Subaward Budget (Fed/Non-Fed) Form 10 Attachments Form	Unchanged
225594	R&R Federal/Non-Federal Budget (up to 5 years) Form	Unchanged
225593	R&R Other Project Information Form	Unchanged
225592	R&R Senior/Key Person Profile (Expanded) Form	Unchanged
225591	SF 424 Application for Federal Assistance Research and Related Cover Form	Unchanged

ICR Details

OMB Control No: 4040-0001	ICR Reference No: 201803-1850-004CF
Status: Historical Active	Previous ICR Reference No: 201709-1850-003CF
Agency/Subagency: ED/IES	Agency Tracking No:
Title: Request for Common Form Usage
Type of Information Collection: RCF No material or nonsubstantive change to a currently approved collection	Common Form ICR:
Type of Review Request:
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/14/2018
	Date Received in OIRA: 03/14/2018
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2019		12/31/2019
Responses	3,421	0	3,420
Time Burden (Hours)	3,421	0	3,420
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: 6

IC Title	Form No.	Form Name
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
R&R Senior/Key Person Profile (Expanded)	4040-0001	Research & Related Senior/Key Person Profile (Expanded)
R&R Other Project Information	4040-0001	Research & Related Other Project Information
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 (Fed/Non-Fed) Form 10 Attachments	4040-0001	5 Year R&R Subaward Budget (Fed/Non-Fed) Attachment(s) Form 10 Attachments

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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	3,421	3,420	0	1	0	0
Annual Time Burden (Hours)	3,421	3,420	0	1	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: The Personal Data form was inadvertently left out of the previous clearance and reason for the 1 hour response increase. It is already part of the approved burden for the IES research grants and this change is to complete the record for ED.

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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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