Regulatory Collection Filing

Social Impact Partnerships to Pay for Results Act (SIPPRA) grant program.

RCF 201811-1505-002CF · Host ICR 201509-4040-001 · OMB 4040-0007

RCF Summary

Request for correction metadata
Host OMB Control No.	4040-0007
Host ICR Reference No.	201509-4040-001
Agency/Subagency	TREAS/DO
Status	Historical Active
Type of RCF	RCF New
OIRA Conclusion Action	Approved without change
Date Received in OIRA	2018-11-06
Conclusion Date	2018-11-12
Related Links	OMB 4040-0007 · ICR 201509-4040-001 · Retrieve Notice of Action (NOA)

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Title: Social Impact Partnerships to Pay for Results Act (SIPPRA) grant program.

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Type of RCF: RCF New
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/12/2018
Retrieve Notice of Action (NOA)	Date Received in OIRA: 11/06/2018
Terms of Clearance:

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Description of Agency Usage: This is a standard form used by applicants for Federal Assistance.

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Authorizing Statute(s): None

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Annual Cost to Federal Government:
Agency Contact: Nevelyn Jones 202 622-1809 [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 for SF-424B Assurances -- Non-construction Programs		7	4	0	Form and Instruction	4040-0007	4040-0007 Assurances - Non-Construction Programs

RCF Summary of Burden:

table that charts list of burden
	Total Approved	Change Due to Agency Discretion
Annual Number of Responses	7	7
Annual Time Burden (Hours)	4	4
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: Use of Common Form