View Information Collection Request (ICR) Package
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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:
4040-0005
ICR Reference No:
201210-4040-001
Status:
Historical Active
Previous ICR Reference No:
200907-4040-002
Agency/Subagency:
EGOV
Agency Tracking No:
17342
Title:
SF-424 Individual
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
Yes
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
01/30/2013
Retrieve Notice of Action (NOA)
Date Received in OIRA:
10/29/2012
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
01/31/2016
36 Months From Approved
01/31/2013
Responses
1
0
8,412
Time Burden (Hours)
1
0
3,824
Cost Burden (Dollars)
0
0
0
Abstract:
The SF-424 Individualform supports the streamlined application requirements for individuals and reduces the administrative burden with a standard government-wide application form.
Authorizing Statute(s):
US Code:
31 USC 6301-6308
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
77 FR 39707
07/05/2012
30-day Notice:
Federal Register Citation:
Citation Date:
77 FR 61405
10/09/2012
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
NEA SF-424 Individual Burden Estimate
4040-0005
SF-424 Individual
NEH SF-424 Individual Burden Estimate
4040-0005
SF-424 Individual
SF-424 Individual Burden Estimate
4040-0005
SF-424 Individual
USDA SF-424 Individual Burden Estimate
4040-0005
SF-424 Individual
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
1
8,412
0
-8,411
0
0
Annual Time Burden (Hours)
1
3,824
0
-3,823
0
0
Annual Cost Burden (Dollars)
0
0
0
0
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:
Yes
Burden Reduction Due to:
Miscellaneous Actions
Short Statement:
This request is to migrate the Individual form to a common form. The burden is thus reduced to only the burden estimated for HHS' use of the Individual form.
Annual Cost to Federal Government:
$19
Does this IC contain surveys, censuses, or employ statistical methods?
No
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Ed Calimag 202 690-7569 Ed.Calimag@hhs.gov
Common Form ICR:
Yes
OIRA authorizes any Agency to begin using a Common Form associated with this ICR automatically after 5 calendar days from the date the agency's RCF including the common form was received in OIRA.
Description/Changes for Common Form Usage:
This request is to migrate the Individual form to a common form.
Approved RCFs using this ICR
Agency/Sub Agency
RCF ID
RCF Title
RCF Status
IC Title
USDA/RHS
201305-0575-001CF
7 CFR 1942-A, Community Facilities Loans
Historical Active
SF-424 Individual Burden Estimate
USDA/NIFA
201404-0524-052CF
SF 424 Discretionary
Historical Active
SF-424 Individual Burden Estimate
USDA/RBS
201303-0570-003CF
Small Socially-Disadvantaged Producer Grant Programs
Historical Active
SF-424 Individual Burden Estimate
NEH
201304-3136-001CF
SF 424Individual 4040-0005
Historical Active
SF-424 Individual Burden Estimate
USDA/RBS
201302-0570-001CF
Rural Microentrepreneur Assistance Program
Historical Active
SF-424 Individual Burden Estimate
NEA
201307-3135-002CF
Request to use Standard Form 424-Individual
Historical Active
SF-424 Individual Burden Estimate
DOT/FTA
201305-2132-013CF
Application for Federal Assistance SF-424
Historical Active
SF-424 Individual Burden Estimate
DOT/FTA
201304-2132-011CF
Application for Federal Assistance SF-424
Historical Active
SF-424 Individual Burden Estimate
DOT/FTA
201304-2132-010CF
Application for Federal Assistance SF-424
Historical Active
SF-424 Individual Burden Estimate
DOT/FTA
201304-2132-009CF
Application for Federal Assistance SF-424
Historical Active
SF-424 Individual Burden Estimate
DOI/ONRR
201604-1012-002CF
Request to use SF-424 Individual common form for ONRR
Historical Active
SF-424 Individual Burden Estimate
USDA/RUS
201610-0572-009CF
SF-424 Application for Federal Assistance - Individual
Historical Active
SF-424 Individual Burden Estimate
TREAS/CDFIF
201609-1559-001CF
CDFI SF-424 Individual Form Use
Historical Active
SF-424 Individual Burden Estimate
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
10/29/2012
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