Regulatory Collection Filing

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

RCF 201811-1505-004CF · Host ICR 201608-4040-012 · OMB 4040-0010

RCF Summary

Host OMB Control No.	4040-0010
Host ICR Reference No.	201608-4040-012
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 4040-0010 · ICR 201608-4040-012 · Retrieve Notice of Action (NOA)

RCF Details

View RCF - OIRA Conclusion

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

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:

Description of Agency Usage: This is a standard form used by applicants for federal assistance.

Authorizing Statute(s): None

Annual Cost to Federal Government:
Agency Contact: Nevelyn Jones 202 622-1809 [email protected]

Common Form Information Collections (IC) in this RCF:

IC Title	Status	Responses	Hours	Dollars	Document Type	Form No.	Form Name
Key Contacts		8	8	0	Form	4040-0010	Key Contacts
Project Abstract		8	8	0	Form	4040-0010	Project Abstract

RCF Summary of Burden:

	Total Approved	Change Due to Agency Discretion
Annual Number of Responses	16	16
Annual Time Burden (Hours)	16	16
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: Agency use of Common Forms