Assurance and Certification of Compliance

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form HHS-690 Assurance of Compliance	Form	Modified	Available
2026-08092.pdf	Supplementary Document	Uploaded 2026-04-24	Available
Form HHS-690 Supporting Statement for OMB final review.docx	Supporting Statement A	Uploaded 2026-04-23	Available
Public Comment on HHS Notice re Assurance of Compliance Form HHS-690.msg	Public Comments	Uploaded 2026-03-27	Available
RE OMB Control Number 0945-0008 Assurance of Compliance Form HHS-690.msg	Public Comments	Uploaded 2026-03-27	Available
OMB Control Number 0945-0008 Assurance of Compliance Form HHS-690 - Public Comment from Hadassah.msg	Public Comments	Uploaded 2026-03-27	Available
60-day PRA comment regarding addition of Conscience Protection Statutes and Religious Nondiscrimination Authorities.msg	Public Comments	Uploaded 2026-03-27	Available
60-day PRA comment regarding meaning of sex.msg	Public Comments	Uploaded 2026-03-27	Available
Comment Assurance of Compliance Form HHS-690 OMB control number 0945-0008 .msg	Public Comments	Uploaded 2026-03-19	Available
Sher_Assurance of Compliance Form HHS-690 OMB Control No. 0945-0008.msg	Public Comments	Uploaded 2026-03-27	Available
2026-01465.pdf	Supplementary Document	Uploaded 2026-03-30	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
238746	Assurance of Compliance	Form	Modified	Assurance of Compliance
236662	Assurance and Certification Requirements	Other-form	Removed
229949	88.4(a) (Update Policies and Procedures; Train Workforce)		Removed
229948	88.4(a) (Review Policies and Procedures)		Removed
229875	88.4(a) (Review and sign assurance and certification)		Removed

ICR Details

OMB Control No: 0945-0008	ICR Reference No: 202603-0945-001
Status: Received in OIRA	Previous ICR Reference No: 202302-0945-001
Agency/Subagency: HHS/OCR	Agency Tracking No:
Title: Assurance and Certification of Compliance
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 04/24/2026

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	04/30/2026
Responses	8,486	360,231
Time Burden (Hours)	33,944	1,317,646
Cost Burden (Dollars)	0	0

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Abstract: The Office for Civil Rights (OCR) collects an Assurance of Compliance (Form HHS-690) from applicants and recipients of federal financial assistance from HHS. The Form certifies compliance with federal civil rights, religious non-discrimination, and conscience protections. This Form ensures covered entities are aware of their obligations under federal civil rights laws, conscience, and religious nondiscrimination laws enforced by OCR and certify that they will comply. Compliance with this assurance is a material condition of the continued receipt of HHS funds, and a subsequent finding of compliance under the authorities contained in this assurance may give rise to liability under the False Claims Act.

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Authorizing Statute(s): PL: Pub.L. 115 - 31 507(d) Name of Law: Consolidated Appropriations Act
   PL: Pub.L. 131 - 135 209 Name of Law: Weldon language applied to Medicare Advantage
   US Code: 42 USC 18023(c) Name of Law: Affordable Care Act
   US Code: 42 USC 300a-7 Name of Law: Church Amendment
   US Code: 20 USC 1681 Name of Law: Title IX of the Education Amendments of 1972
   US Code: 42 USC 238n Name of Law: Coats-Snowe Amendment,
  

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:
	91 FR 3205	01/26/2026
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 79	04/24/2026
Did the Agency receive public comments on this ICR? Yes

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

table that charts list of burden

IC Title	Form No.	Form Name
88.4(a) (Review Policies and Procedures)
88.4(a) (Review and sign assurance and certification)
88.4(a) (Update Policies and Procedures; Train Workforce)
Assurance and Certification Requirements
Assurance of Compliance	HHS-690	Assurance of Compliance

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ICR Summary of Burden

table that charts list of burden

	Total Request	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	8,486	360,231	0	-351,745	0	0
Annual Time Burden (Hours)	33,944	1,317,646	0	-1,283,702	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: Yes

Burden Reduction Due to: Using Information Technology

Short Statement: As Applicants/Recipients now may file electronically via the electronic portal, the burden was reduced in not requiring additional documentation. OCR expects the majority of respondents to complete the form through electronic submission.

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Annual Cost to Federal Government:

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]? Yes

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:  No

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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: 04/24/2026

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