Information Collection

HHS SF-424 Short Organizational Burden Estimate 4040-0003

IC 253831 under ICR 202205-0570-014CF · OMB 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⚠️ Notice: This information collection may be referencing outdated material.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

View RCF Information Collection (IC)

IC Title:	HHS SF-424 Short Organizational Burden Estimate 4040-0003	Agency IC Tracking Number:	0570-0067

IC Status: New

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: 1,976	Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,976	1,976
Annual IC Time Burden (Hours)	1,976	1,976
Annual IC Cost Burden (Dollars)	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.