SF-424 Mandatory

Forms and Documents

Document Name	Status
Form 4040-0002 SF-424 Mandatory Form and Instructi	New
Supporting Statement 4040-0002 SF424 Mandatory.docx Supporting Statement A	2019-11-12

IC Document Collections

IC ID	Document Title	Status
238521	SF-424 Mandatory Form and Instructi	New

ICR Details

OMB Control No: 4040-0020	ICR Reference No: 201911-4040-005
Status: Active	Previous ICR Reference No:
Agency/Subagency: EGOV	Agency Tracking No:
Title: SF-424 Mandatory
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  Yes
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/22/2020
	Date Received in OIRA: 11/20/2019
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2023	36 Months From Approved
Responses	5,761	0	0
Time Burden (Hours)	5,761	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The SF-424 Mandatory Form provides the Federal grant-making agencies an alternative to the Standard Form 424 data set and form. Agencies may use the SF-424 Mandatory Form for grant programs not required to collect all the data that is required on the SF-424 core data set and form.

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

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 8731	03/11/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 22864	05/20/2019
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
SF-424 Mandatory	4040-0002	Application for Federal Assistance - SF-424 Mandatory

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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	5,761	0	0	5,761	0	0
Annual Time Burden (Hours)	5,761	0	0	5,761	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: As this is a Common Form, burden is reported only for HHS. An estimate of the total burden of the information collection was developed. HHS receives approximately 5,761 applications annually and estimates that it takes applicants approximately 1 hour on average to complete each application. Cumulatively, HHS reports that the total burden to applicants to be approximately 5,761 hours.

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Annual Cost to Federal Government: $224,679

Does this IC contain surveys, censuses, or employ statistical methods? No

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.     No

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.     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

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Common Form ICR:  Yes

Description/Changes for Common Form Usage:  This form is used by multiple agencies for collecting information related to Mandatory grant programs that are not included in the standard SF-424.

Approved RCFs using this ICR

Agency/Sub Agency	RCF ID	RCF Title	RCF Status	IC Title

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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: 11/20/2019

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