Information Collection

HHS SF-424 Burden Collection

IC 224988 under ICR 201912-0575-002CF · 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⚠️ Notice: This information collection may be referencing outdated material.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 4040-0004 SF424 HF.pdf	Form

IC Title:

HHS SF-424 Burden Collection

Agency IC Tracking Number:

0575-0198

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

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	4040-0004 SF424 HF.pdf		Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 35

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	Previously Approved
Annual Number of Responses for this IC	35	35
Annual IC Time Burden (Hours)	35	35
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.