Regulatory Collection Filing

SF 425-V1

RCF 202202-0570-019CF · Host ICR 202112-4040-004 · OMB 4040-0014

RCF Summary

Request for correction metadata
Host OMB Control No.	4040-0014
Host ICR Reference No.	202112-4040-004
Agency/Subagency	USDA/RBS
Status	Active
Type of RCF	RCF Recertification
OIRA Conclusion Action	Approved
Date Received in OIRA	2022-02-25
Conclusion Date	2022-02-25
Agency Tracking No.	0570-0052
Related Links	OMB 4040-0014 · ICR 202112-4040-004 · Previous RCF 201906-0570-005CF · Retrieve Notice of Action (NOA)

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Title: SF 425-V1

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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:

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Description of Agency Usage: Federal Financial Report

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Authorizing Statute(s): None

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Annual Cost to Federal Government: $2,340
Agency Contact: Robin Jones 202 772-1172 [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		20	20	0	Form and Instruction	4040-0014	SF-425 Federal Financial Report

RCF Summary of Burden:

table that charts list of burden
	Total Approved	Previously Approved
Annual Number of Responses	20	20
Annual Time Burden (Hours)	20	20
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: