Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 4040-0003	ICR Reference No: 201508-4040-009
Status: Historical Active	Previous ICR Reference No: 200907-4040-001
Agency/Subagency: EGOV	Agency Tracking No:
Title: SF-424 Short Organizational (Short) 4040-0003
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR: Yes
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 01/15/2016
Retrieve Notice of Action (NOA)	Date Received in OIRA: 09/29/2015
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2019	36 Months From Approved	11/30/2011
Responses	8,388	0	10,697
Time Burden (Hours)	4,194	0	3,941
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses	8,388	10,697	-6,212	3,903
Annual Time Burden (Hours)	4,194	3,941	-1,699	1,952
Annual Cost Burden (Dollars)	0	0	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: This form has been categorized as a common form as it is used by all federal grant-making agencies. HHS owns the form and reports only HHS burden hours. Other federal grant-making agencies must request use of the form and are responsible for reporting burden hours.