Regulatory Collection Filing

Standard Form 270, "Request for Advance or Reimbursement"

RCF 202506-0575-001CF · Host ICR 202503-4040-001 · OMB 4040-0012

RCF Summary

Request for correction metadata
Host OMB Control No.	4040-0012
Host ICR Reference No.	202503-4040-001
Agency/Subagency	USDA/RHS
Status	Active
Type of RCF	RCF Recertification
OIRA Conclusion Action	Approved
Date Received in OIRA	2025-06-20
Conclusion Date	2025-06-20
Agency Tracking No.	0575-0180
Related Links	OMB 4040-0012 · ICR 202503-4040-001 · Previous RCF 202411-0575-005CF · Retrieve Notice of Action (NOA)

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Title: Standard Form 270, "Request for Advance or Reimbursement"

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Type of RCF: RCF Recertification
OIRA Conclusion Action: Approved	Conclusion Date: 06/20/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/20/2025
Terms of Clearance:

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Description of Agency Usage: This form is used by the grantee to request advances or reimbursement of cash outlays. This form OMB No. is 4040-0012. This PRA package OMB No. is 0575-0180

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Authorizing Statute(s): None

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Annual Cost to Federal Government:
Agency Contact: Lisa Day 971 313-4750 [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
4040-0012 SF-270 Request for Advance or Reimbursement Form		90	90	0	Form	4040-0012	SF-270 Request for Advance or Reimbursement Form

RCF Summary of Burden:

table that charts list of burden
	Total Approved	Previously Approved
Annual Number of Responses	90	90
Annual Time Burden (Hours)	90	90
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: