View Information Collection Request (ICR) Package
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View Information Collection (IC) List
View Supporting Statement and Other Documents
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:
4040-0012
ICR Reference No:
201509-4040-004
Status:
Historical Active
Previous ICR Reference No:
201307-4040-002
Agency/Subagency:
EGOV
Agency Tracking No:
Title:
SF-270: Request for Advance or Reimbursement 4040-0012
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:
10/13/2015
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
01/31/2019
36 Months From Approved
10/31/2013
Responses
100,000
0
100,000
Time Burden (Hours)
100,000
0
100,000
Cost Burden (Dollars)
0
0
0
Abstract:
Grantees use this form to request funds for all nonconstruction grant programs when letters of credit or predetermined advance methods are not used.
Authorizing Statute(s):
US Code:
31 USC 503 and 1111
EO: EO 11541
US Code:
41 USC 405
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:
79 FR 65969
11/06/2014
30-day Notice:
Federal Register Citation:
Citation Date:
80 FR 7603
02/11/2015
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
4040-0012 SF-270 Request for Advance or Reimbursement Form
4040-0012
SF-270 Request for Advance or Reimbursement Form
SF-270: Request for Advance or Reimbursement
0348-0004
SF-270
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
100,000
100,000
0
0
0
0
Annual Time Burden (Hours)
100,000
100,000
0
0
0
0
Annual Cost Burden (Dollars)
0
0
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:
The SF-270 Request for Advance or Reimbursement Form is a common form used across all Federal grant-making agencies.
Annual Cost to Federal Government:
$3,900,000
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:
All Federal grant-making agencies require grant recipients to use this form. This IC shall only report for HHS. All other Federal agencies are responsible for request to use the common form and report their respective burden hours.
Approved RCFs using this ICR
Agency/Sub Agency
RCF ID
RCF Title
RCF Status
IC Title
USDA/AMS
201602-0581-009CF
Request for Advance or Reimbursement
Historical Active
4040-0012 SF-270 Request for Advance or Reimbursement Form
USDA/RHS
201605-0575-003CF
Request for Advance or Reimbursement
Historical Active
4040-0012 SF-270 Request for Advance or Reimbursement Form
DOI/BLM
201606-1004-010CF
BLM - SF 270 - Request for Advance or Reimbursement Common Form Usage
Historical Active
4040-0012 SF-270 Request for Advance or Reimbursement Form, 4040-0012 SF-270 Request for Advance or Reimbursement Form
USDA/RUS
201701-0572-012CF
Request for Advance or Reimbursement SF-270
Historical Active
4040-0012 SF-270 Request for Advance or Reimbursement Form
USDA/RUS
201701-0572-016CF
Request for Advance or Reimbursement
Historical Active
4040-0012 SF-270 Request for Advance or Reimbursement Form
USDA/AMS
201610-0581-015CF
SF-270 Request for Advance/Reimbursement
Historical Active
4040-0012 SF-270 Request for Advance or Reimbursement Form, 4040-0012 SF-270 Request for Advance or Reimbursement Form, 4040-0012 SF-270 Request for Advance or Reimbursement Form, 4040-0012 SF-270 Request for Advance or Reimbursement Form, 4040-0012 SF-270 Request for Advance or Reimbursement Form
USDA/RBS
201605-0570-011CF
SF-270 - Request for Advance or Reimbursement
Historical Active
4040-0012 SF-270 Request for Advance or Reimbursement Form
USDA/RHS
201607-0575-010CF
SF-270 Request for Advance or Reimbursement
Historical Active
4040-0012 SF-270 Request for Advance or Reimbursement Form, 4040-0012 SF-270 Request for Advance or Reimbursement Form
USDA/RBS
201701-0570-027CF
Request for Advance of Reimbursement SF-270
Historical Active
4040-0012 SF-270 Request for Advance or Reimbursement Form
USDA/RBS
201612-0570-023CF
Request for Advance or Reimbursement - SF-270
Historical Active
4040-0012 SF-270 Request for Advance or Reimbursement Form
USDA/RBS
201612-0570-018CF
SF - 270 Request for Advance or Reimbursement
Historical Active
4040-0012 SF-270 Request for Advance or Reimbursement Form, 4040-0012 SF-270 Request for Advance or Reimbursement Form
USDA/RUS
201701-0572-023CF
Request for Advance or Reimbursement SF-270
Historical Active
4040-0012 SF-270 Request for Advance or Reimbursement Form
USDA/RUS
201707-0572-028CF
SF-270 Request for Advance or Reimbursement
Historical Active
4040-0012 SF-270 Request for Advance or Reimbursement Form, 4040-0012 SF-270 Request for Advance or Reimbursement Form, 4040-0012 SF-270 Request for Advance or Reimbursement Form
DOT/FMCSA
201809-2126-006CF
SF-270 Request for Advance or Reimbursement
Historical Active
4040-0012 SF-270 Request for Advance or Reimbursement Form
USDA/RUS
201710-0572-036CF
Request for Advance or Reimbursement
Historical Active
4040-0012 SF-270 Request for Advance or Reimbursement Form
USDA/AMS
201901-0581-002CF
SF-270 Request for Advance or Reimbursement
Historical Active
4040-0012 SF-270 Request for Advance or Reimbursement Form
USDA/RBS
201802-0570-042CF
SF-270, Request for Advance or Reimbursement
Historical Active
4040-0012 SF-270 Request for Advance or Reimbursement Form
USDA/FS
201802-0596-008CF
SF-270 Request For Advance or Reimbursement
Historical Active
4040-0012 SF-270 Request for Advance or Reimbursement Form
USDA/RHS
201810-0575-004CF
SF-270 Request for Advance or Reimbursement
Historical Active
4040-0012 SF-270 Request for Advance or Reimbursement Form
USDA/RUS
201804-0572-048CF
Request for Advance or Reimbursement (SF-270)
Historical Active
4040-0012 SF-270 Request for Advance or Reimbursement Form, 4040-0012 SF-270 Request for Advance or Reimbursement Form
USDA/RHS
201804-0575-028CF
SF-270 Request for Advance or Reimbursement
Historical Active
4040-0012 SF-270 Request for Advance or Reimbursement Form
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:
10/13/2015
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