Regulatory Collection Filing

BLM 424-Mandatory Common Form Usage

RCF 201606-1004-004CF · Host ICR 201505-4040-002 · OMB 4040-0002

RCF Summary

Request for correction metadata
Host OMB Control No.	4040-0002
Host ICR Reference No.	201505-4040-002
Agency/Subagency	DOI/BLM
Status	Historical Active
Type of RCF	RCF New
OIRA Conclusion Action	Approved without change
Date Received in OIRA	2016-06-13
Conclusion Date	2016-06-18
Related Links	OMB 4040-0002 · ICR 201505-4040-002 · Retrieve Notice of Action (NOA)

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Title: BLM 424-Mandatory Common Form Usage

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Type of RCF: RCF New
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/18/2016
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/13/2016
Terms of Clearance:

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Description of Agency Usage: Request to enable BLM to use the SF-424 Mandatory form.

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Authorizing Statute(s): None

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Annual Cost to Federal Government: $106,028
Agency Contact: Jean Sonneman 202 785-6577 [email protected]

Common Form Information Collections (IC) in this RCF:

table that charts list of ICs
IC Title	Status	Responses	Hours	Dollars	Document Type	Form No.	Form Name
HHS burden estimate for the SF-424 Mandatory (M)		1,019	1,019	0	Other
HHS burden estimate for the SF-424 Mandatory (M)		1,020	1,020	0	Other

RCF Summary of Burden:

table that charts list of burden
	Total Approved	Change Due to Agency Discretion
Annual Number of Responses	2,039	2,039
Annual Time Burden (Hours)	2,039	2,039
Annual Cost Burden (Dollars)	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: Initial request for BLM to use this common form.