Information Collection

HHS SF-424 Burden Collection

IC 187902 under ICR 201910-4040-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Document Name Document Type
Form SF-424 HHS SF-424 Burden Collection Form
SF-424 Application for Federal Assistance 4040-0004 SF424 HF.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	HHS SF-424 Burden Collection	Agency IC Tracking Number:

Is this a Common Form? Yes		IC Status: Modified

Obligation to Respond: Voluntary

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

Information Collection 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	4040-0004 SF424 HF.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: 20,803	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	20,803	5,920	14,883
Annual IC Time Burden (Hours)	20,803	5,920	14,883
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.