Regulatory Collection Filing

BLM - 425, Federal Financial Report

RCF 201606-1004-009CF · Host ICR 201509-4040-005 · OMB 4040-0014

RCF Summary

Host OMB Control No.	4040-0014
Host ICR Reference No.	201509-4040-005
Agency/Subagency	DOI/BLM
Status	Historical Active
Type of RCF	RCF New
OIRA Conclusion Action	Approved without change
Date Received in OIRA	2016-06-14
Conclusion Date	2016-06-16
Related Links	OMB 4040-0014 · ICR 201509-4040-005 · Retrieve Notice of Action (NOA)

RCF Details

View RCF - OIRA Conclusion

Title: BLM - 425, Federal Financial Report

Type of RCF: RCF New
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/16/2016
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/14/2016
Terms of Clearance:

Description of Agency Usage: Burden request for SF-425, Federal Financial Report common form usage.

Authorizing Statute(s): None

Annual Cost to Federal Government: $216,550
Agency Contact: Jean Sonneman 202 785-6577 [email protected]

Common Form Information Collections (IC) in this RCF:

IC Title	Status	Responses	Hours	Dollars	Document Type	Form No.	Form Name
SF-425 Federal Financial Report 4040-0014		1,525	1,525	0	Form	4040-0014 SF-425 Federal Financial Report	SF-425 Federal Financial Report
SF-425 Federal Financial Report 4040-0014		1,525	1,525	0	Form	4040-0014 SF-425 Federal Financial Report	SF-425 Federal Financial Report

RCF Summary of Burden:

	Total Approved	Change Due to Agency Discretion
Annual Number of Responses	3,050	3,050
Annual Time Burden (Hours)	3,050	3,050
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 submission for common form usage.