HHS SF-424 Short Organizational Burden Estimate 4040-0003

SF-424 Short Organizational (Short) 4040-0003

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 4040-0003 can be found here:

Documents and Forms

Document Name Document Type
Form 4040-0003 HHS SF-424 Short Organizational Burden Estimate 4040-0003 Form
4040-0003 Application for Federal Domestic Assistance - Short Orga 4040-0003 SF424 Short Org.pdf Form

Information Collection (IC) Details

IC Title:	HHS SF-424 Short Organizational Burden Estimate 4040-0003	Agency IC Tracking Number:

Is this a Common Form? Yes		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 2 CFR 225 2 CFR 215 2 CFR 230 5 CFR 1320.5 2 CFR 220

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	4040-0003	Application for Federal Domestic Assistance - Short Organizational	4040-0003 SF424 Short Org.pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 936	Number of Respondents for Small Entity: 1

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	936	-7,452	8,388
Annual IC Time Burden (Hours)	936	-3,258	4,194
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.