SF-424 Project/Performance Site Location(s) Form; Key Contacts; Project Abstract

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 4040-0010 Project/Performance Site Location	Form	Unchanged	Available
Form 4040-0010 Project Performance Site Location	Form	Unchanged	Repair queued
Form 4040-0010 Project Abstract	Form	Unchanged	Available
Form 4040-0010 Project Abstract	Form	Unchanged	Repair queued
Form 4040-0010 Key Contacts	Form	Unchanged	Available
Form 4040-0010 Key Contacts	Form	Unchanged	Repair queued
4040-0010 SSA_2022.docx	Supporting Statement A	Uploaded 2022-09-19	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
223157	Project Performance Site Location	Form	Unchanged	Project/Performance Site Location
223157	Project Performance Site Location	Form	Unchanged
223156	Project Abstract	Form	Unchanged	Project Abstract
223156	Project Abstract	Form	Unchanged
185702	Key Contacts	Form	Unchanged	Key Contacts
185702	Key Contacts	Form	Unchanged

ICR Details

OMB Control No: 4040-0010	ICR Reference No: 202208-4040-003
Status: Historical Active	Previous ICR Reference No: 201907-4040-001
Agency/Subagency: EGOV	Agency Tracking No: 15380
Title: SF-424 Project/Performance Site Location(s) Form; Key Contacts; Project Abstract
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  Yes
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/08/2022
Retrieve Notice of Action (NOA)	Date Received in OIRA: 10/06/2022
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2025	36 Months From Approved	12/31/2022
Responses	132,077	0	132,077
Time Burden (Hours)	132,077	0	132,077
Cost Burden (Dollars)	0	0	0

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Abstract: In compliance with section 3507(a)(1)(D) of the Paperwork Reduction Act of 1995, the Electronic Government Office (EGOV), Department of Health and Human Services, has submitted an Information Collection Request (ICR), described below, to the Office of Management and Budget (OMB) for review and approval. The ICR is for reinstatement of a previously-approved information collection assigned OMB control number 4040-0010, which expires on October 31, 2019. The ICR also requests categorizing the form as a common form, meaning HHS will only request approval for its own use of the form rather than aggregating the burden estimate across all Federal Agencies as was done for previous actions on this OMB control number.

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Authorizing Statute(s): PL: Pub.L. 109 - 282 2590 Name of Law: Federal Funding 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:
	87 FR 39536	07/01/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 60176	10/04/2022
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
Key Contacts	4040-0010	Key Contacts
Project Abstract	4040-0010	Project Abstract
Project Performance Site Location	4040-0010	Project/Performance Site Location

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ICR Summary of Burden

table that charts list 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	132,077	132,077	0	0	0	0
Annual Time Burden (Hours)	132,077	132,077	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $5,151,003

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? No

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Common Form ICR:  Yes

OIRA authorizes any Agency to begin using a Common Form associated with this ICR automatically after 5 calendar days from the date the agency's RCF including the common form was received in OIRA.

Description/Changes for Common Form Usage: 

Approved RCFs using this ICR

table that charts list of RCF

Agency/Sub Agency	RCF ID	RCF Title	RCF Status	IC Title
DOC/ITA	202311-0625-004CF	SF-424 Project/Performance Site Location(s) Form; Key Contacts; Project Abstract	Active	Key Contacts, Project Abstract, Project Performance Site Location
DOL/DM	202211-1225-001CF	SF-424 Project/Performance Site Location(s) Form; Key Contacts; Project Abstract --DOL Usage	Active	Key Contacts, Project Abstract, Project Performance Site Location
USDA/NIFA	202211-0524-001CF	Key Contracts and Project/Performance Site Locations(s)	Active	Key Contacts, Project Performance Site Location
DOT/FAA	202211-2120-001CF	FAA Aircraft Pilots Workforce Development Grant Program - Key Contact, Project Location and Abstract Forms Request	Active	Key Contacts, Project Abstract, Project Abstract, Project Performance Site Location, Project Performance Site Location
DOT/FMCSA	202211-2126-001CF	Key Contacts	Active	Key Contacts
TREAS/DO	202211-1505-002CF	Social Impact Partnerships to Pay for Results Act (SIPPRA) grant program	Active	Key Contacts, Project Abstract
DOW/DODDEP	202211-0704-003CF	SF-424 Project/ Performance Site Location(s) Form; Key Contacts; Project Abstract	Active	Project Performance Site Location
DOT/FAA	202211-2120-002CF	FAA Aviation Maintenance Technical Workers Workforce Development Grant Program - Key Contacts, Project Site Location & Project Abstract forms request	Active	Key Contacts, Key Contacts, Project Abstract, Project Abstract, Project Performance Site Location, Project Performance Site Location
TREAS/DO	202211-1505-001CF	Application, Reports, and Recordkeeping for the Social Impact Partnerships to Pay for Results Act (SIPPRA) grant program.	Active	Project Performance Site Location
DOC/ITA	202311-0625-005CF	SF-424 Project/Performance Site Location(s) Form; Key Contacts; Project Abstract	Active	Key Contacts, Project Abstract, Project Performance Site Location
VA	202307-2900-004CF	Project Abstract, Project/Performance Site Location(s), Key Contacts	Active	Key Contacts, Project Abstract, Project Performance Site Location
DOC/NTIA	202311-0660-001CF	SF-424 Project/Performance Site Location(s); Key Contacts; Project Abstract for NTIA Broadband Grant Programs	Active	Key Contacts, Project Abstract, Project Performance Site Location
DOC/NOAA	202311-0648-001CF	NOAA - SF-424 Key Contacts, Project Abstract; Project/Performance Site Locations	Active	Key Contacts, Project Abstract, Project Performance Site Location

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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: 10/06/2022

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