Regulatory Collection Filing

SF-424 Application for Federal Assistance

RCF 201912-0575-007CF · Host ICR 201910-4040-001 · OMB 4040-0004

RCF Summary

Request for correction metadata
Host OMB Control No.	4040-0004
Host ICR Reference No.	201910-4040-001
Agency/Subagency	USDA/RHS
Status	Active
Type of RCF	RCF Recertification
OIRA Conclusion Action	Approved
Date Received in OIRA	2019-12-30
Conclusion Date	2019-12-30
Agency Tracking No.	0575-0043
Related Links	OMB 4040-0004 · ICR 201910-4040-001 · Previous RCF 201810-0575-001CF · Retrieve Notice of Action (NOA)

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Title: SF-424 Application for Federal Assistance

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Type of RCF: RCF Recertification
OIRA Conclusion Action: Approved	Conclusion Date: 12/30/2019
Retrieve Notice of Action (NOA)	Date Received in OIRA: 12/30/2019
Terms of Clearance:

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Description of Agency Usage: This is a multi-purpose form that is used as the application form for the pre-development grant program, the technical assistance grant program, and the site option loan program.

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Authorizing Statute(s): None

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Annual Cost to Federal Government:
Agency Contact: Andrea Birmingham 202 720-1489

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 SF-424 Burden Collection		100	100	0	Form	SF-424	Application for Federal Assistance

RCF Summary of Burden:

table that charts list of burden
	Total Approved	Previously Approved
Annual Number of Responses	100	100
Annual Time Burden (Hours)	100	100
Annual Cost Burden (Dollars)	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: