National 4-H Conference Registration Form, Leadership Position Interest Form, and Scholarship Interest Form

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0524-0054 National 4-H Conference Scholarship Form SPD-15 and EO 14168 Edits	Form	Modified	Available
Form 0524-0054 National 4-H Conference Registration Form SPD-15 and EO 14168 Edits	Form	Modified	Available
Form 0524-0054 National 4-H Conference Leadership Interest Form SPD-15 and EO 14168 Edits	Form	Modified	Available
Form 0524-NEW National 4-H Conference Scholarship Form	Form	Modified	Available
Form 0524-NEW National 4-H Conference Leadership Interest Form	Form	Modified	Available
Form 0524-NEW National 4-H Conference Registration Form	Form	Modified	Available
Form 0524-NEW National 4-H Conference Registration Form, Leadership Position Interest Form, and Scholarship Interest Form	Form	Modified	Missing upstream
0524-0054 4-H Non-Substantive Change Cover Sheet.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-05-07	Repair queued
0524-0054 4-H Non-Substantive Change Cover Sheet.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-05-07	Repair queued
0524-NEW 4-H Conference Forms Supp. Stmt. A 1-12-2024.docx	Supporting Statement A	Uploaded 2024-01-12	Available
0524-NEW 4-H Conference Forms Supp. Stmt. A 1-12-2024.docx	Supporting Statement A	Uploaded 2024-01-12	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
263877	National 4-H Conference Registration Form, Leadership Position Interest Form, and Scholarship Interest Form	Form	Modified	National 4-H Conference Scholarship Form SPD-15 and EO 14168 Edits
263877	National 4-H Conference Registration Form, Leadership Position Interest Form, and Scholarship Interest Form	Form	Modified	National 4-H Conference Registration Form SPD-15 and EO 14168 Edits
263877	National 4-H Conference Registration Form, Leadership Position Interest Form, and Scholarship Interest Form	Form	Modified	National 4-H Conference Leadership Interest Form SPD-15 and EO 14168 Edits
263877	National 4-H Conference Registration Form, Leadership Position Interest Form, and Scholarship Interest Form	Form	Modified	National 4-H Conference Scholarship Form
263877	National 4-H Conference Registration Form, Leadership Position Interest Form, and Scholarship Interest Form	Form	Modified	National 4-H Conference Leadership Interest Form
263877	National 4-H Conference Registration Form, Leadership Position Interest Form, and Scholarship Interest Form	Form	Modified	National 4-H Conference Registration Form
263877	National 4-H Conference Registration Form, Leadership Position Interest Form, and Scholarship Interest Form	Form	Modified

ICR Details

OMB Control No: 0524-0054	ICR Reference No: 202503-0524-001
Status: Active	Previous ICR Reference No: 202312-0524-002
Agency/Subagency: USDA/NIFA	Agency Tracking No: Revision Compliant with EO 14168
Title: National 4-H Conference Registration Form, Leadership Position Interest Form, and Scholarship Interest Form
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/28/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/20/2025
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2027	01/31/2027	01/31/2027
Responses	400	0	400
Time Burden (Hours)	700	0	700
Cost Burden (Dollars)	0	0	0

---

Abstract: This is a new information collection intended to support the successful planning and delivery of activities associated with the National 4-H Conference. The information collection is essential to provide the necessary instructions and paperwork to eligible registrants who would like to attend, serve in a leadership role, or receive scholarship funding at the National 4–H Conference.

---

Authorizing Statute(s): PL: Pub.L. 110 - 246 7511(f)(2) Name of Law: Food, Conservation, and Energy Act of 2008
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 12910	03/01/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 86316	12/13/2023
Did the Agency receive public comments on this ICR? No

---

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

table that charts list of burden

IC Title	Form No.	Form Name
National 4-H Conference Registration Form, Leadership Position Interest Form, and Scholarship Interest Form	0524-NEW, 0524-NEW, 0524-NEW, 0524-0054, 0524-0054, 0524-0054	National 4-H Conference Registration Form ,   National 4-H Conference Leadership Interest Form ,   National 4-H Conference Scholarship Form ,   National 4-H Conference Leadership Interest Form SPD-15 and EO 14168 Edits ,   National 4-H Conference Registration Form SPD-15 and EO 14168 Edits ,   National 4-H Conference Scholarship Form SPD-15 and EO 14168 Edits

---

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	400	400	0	0	0	0
Annual Time Burden (Hours)	700	700	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:

---

Annual Cost to Federal Government: $25,690

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.     Yes

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.     Yes

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

---

Common Form ICR:  No

---

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: 05/20/2025

---