Regulatory Collection Filing

SF-425 Financial Report

RCF 202202-0560-003CF · Host ICR 202112-4040-004 · OMB 4040-0014

RCF Summary

Host OMB Control No.	4040-0014
Host ICR Reference No.	202112-4040-004
Agency/Subagency	USDA/FSA
Status	Active
Type of RCF	RCF Recertification
OIRA Conclusion Action	Approved
Date Received in OIRA	2022-02-25
Conclusion Date	2022-02-25
Related Links	OMB 4040-0014 · ICR 202112-4040-004 · Previous RCF 202011-0560-001CF · Retrieve Notice of Action (NOA)

RCF Details

View RCF - OIRA Conclusion

Title: SF-425 Financial Report

Type of RCF: RCF Recertification
OIRA Conclusion Action: Approved	Conclusion Date: 02/25/2022
Retrieve Notice of Action (NOA)	Date Received in OIRA: 02/25/2022
Terms of Clearance:

Description of Agency Usage: The form is needed for the Certified Mediation Program (0560-0165).

Authorizing Statute(s): None

Annual Cost to Federal Government:
Agency Contact: Mary Ann Ball 202-720-4283 [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		126	126	0	Form and Instruction	4040-0014	SF-425 Federal Financial Report

RCF Summary of Burden:

	Total Approved	Previously Approved
Annual Number of Responses	126	126
Annual Time Burden (Hours)	126	126
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: