Regulatory Collection Filing

SF 425 - Federal Financial Report for BIA Use

RCF 201610-1076-001CF · Host ICR 201509-4040-005 · OMB 4040-0014

RCF Summary

Request for correction metadata
Host OMB Control No.	4040-0014
Host ICR Reference No.	201509-4040-005
Agency/Subagency	DOI/BIA
Status	Historical Active
Type of RCF	RCF New
OIRA Conclusion Action	Approved without change
Date Received in OIRA	2016-10-11
Conclusion Date	2016-10-17
Related Links	OMB 4040-0014 · ICR 201509-4040-005 · Retrieve Notice of Action (NOA)

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Title: SF 425 - Federal Financial Report for BIA Use

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Type of RCF: RCF New
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/17/2016
Retrieve Notice of Action (NOA)	Date Received in OIRA: 10/11/2016
Terms of Clearance:

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Description of Agency Usage: SF 425 - Federal Financial Report for BIA Use. This form is provided to State, Local and tribal governments to obtain or maintain a benefit.

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Authorizing Statute(s): None

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Annual Cost to Federal Government: $6,368
Agency Contact: Ashley Fry 202 208-5808 [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
SF-425 Federal Financial Report 4040-0014		180	180	0	Form	4040-0014 SF-425 Federal Financial Report	SF-425 Federal Financial Report

RCF Summary of Burden:

table that charts list of burden
	Total Approved	Change Due to Agency Discretion
Annual Number of Responses	180	180
Annual Time Burden (Hours)	180	180
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: This RCF documents the usage of SF 425 by BIA.