View Information Collection Request (ICR) Package
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IC List
Burden
Misc.
Common Form Info.
Certification
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:
4040-0014
ICR Reference No:
201509-4040-005
Status:
Historical Active
Previous ICR Reference No:
201307-4040-004
Agency/Subagency:
EGOV
Agency Tracking No:
Title:
SF-425 Federal Financial Report 4040-0014
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:
10/20/2015
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
01/31/2019
36 Months From Approved
02/28/2015
Responses
100,000
0
1,200,000
Time Burden (Hours)
100,000
0
1,200,000
Cost Burden (Dollars)
0
0
0
Abstract:
This is a standard governmentwide form for grantees to use in reporting financial status and cash disbursement under grants.
Authorizing Statute(s):
PL:
Pub.L. 106 - 107 3(2)
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 65961
11/06/2014
30-day Notice:
Federal Register Citation:
Citation Date:
80 FR 7596
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
Federal Financial Report
SF-425
Federal Financial Report
Federal Financial Report Attachment
SF-425A
Federal Financial Report Attachment
SF-425 Federal Financial Report 4040-0014
4040-0014 SF-425 Federal Financial Report
SF-425 Federal Financial Report
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
1,200,000
0
-1,100,000
0
0
Annual Time Burden (Hours)
100,000
1,200,000
0
-1,100,000
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 form is now being classified as a Common Form. Burden hours are reported for HHS only. Other Federal grant-making agencies using the form are responsible for reporting burden hours.
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:
Recipients of financial assistance from any of the Federal grant-making agencies are required to use this form. HHS is responsible for renewal and reporting of burden hours for the 4040-0014. Other Federal agencies that wish to use the form are required to file a request for use from OMB and report burden hours accordingly.
Approved RCFs using this ICR
Agency/Sub Agency
RCF ID
RCF Title
RCF Status
IC Title
USDA/AMS
201602-0581-010CF
Federal Financial Report
Historical Active
SF-425 Federal Financial Report 4040-0014
DOI/ONRR
201604-1012-005CF
SF-425 Federal Financial Report usage for ONRR
Historical Active
SF-425 Federal Financial Report 4040-0014
DOI/OSMRE
201605-1029-005CF
Request to use SF-425 - Federal Financial Report- State, Local & Tribal Govt. for OSMRE
Historical Active
SF-425 Federal Financial Report 4040-0014
DOI/BLM
201606-1004-009CF
BLM - 425, Federal Financial Report
Historical Active
SF-425 Federal Financial Report 4040-0014, SF-425 Federal Financial Report 4040-0014
DOI/NPS
201609-1024-009CF
SF-425 - Federal Financial Report common form usage for NPS.
Historical Active
SF-425 Federal Financial Report 4040-0014
USDA/RHS
201605-0575-004CF
SF-425 -- Financial Status Report
Historical Active
SF-425 Federal Financial Report 4040-0014
DOI/BIA
201610-1076-001CF
SF 425 - Federal Financial Report for BIA Use
Historical Active
SF-425 Federal Financial Report 4040-0014
USDA/RUS
201701-0572-017CF
Federal Financial Report SF 425
Historical Active
SF-425 Federal Financial Report 4040-0014
USDA/AMS
201610-0581-016CF
SF-425 Federal Financial Report
Historical Active
SF-425 Federal Financial Report 4040-0014, SF-425 Federal Financial Report 4040-0014, SF-425 Federal Financial Report 4040-0014, SF-425 Federal Financial Report 4040-0014, SF-425 Federal Financial Report 4040-0014
USDA/RHS
201607-0575-012CF
SF-425 Federal Financial Report
Historical Active
SF-425 Federal Financial Report 4040-0014, SF-425 Federal Financial Report 4040-0014
USDA/RBS
201612-0570-014CF
SF-425 Federal Financial Report
Historical Active
SF-425 Federal Financial Report 4040-0014
USDA/APHIS
201702-0579-015CF
Federal Financial Report (4040-0014)
Historical Active
SF-425 Federal Financial Report 4040-0014, SF-425 Federal Financial Report 4040-0014
USDA/NIFA
201702-0524-067CF
Federal Financial Report
Historical Active
SF-425 Federal Financial Report 4040-0014
USDA/RUS
201701-0572-024CF
Federal Financial Report SF-425
Historical Active
SF-425 Federal Financial Report 4040-0014
USDA/RBS
201605-0570-009CF
SF-425 - Federal Financial Report
Historical Active
SF-425 Federal Financial Report 4040-0014
DOT/FAA
201704-2120-005CF
Aviation Research Grants Program
Historical Active
SF-425 Federal Financial Report 4040-0014
USDA/FNS
201706-0584-012CF
SF-425 Federal Financial Report (FNS)
Historical Active
SF-425 Federal Financial Report 4040-0014, SF-425 Federal Financial Report 4040-0014
DOC/NTIA
201709-0660-013CF
Federal Financial Report (SF-425) for 911 Grant Program
Historical Active
SF-425 Federal Financial Report 4040-0014
USDA/RUS
201707-0572-030CF
SF-425 Federal Financial Report
Historical Active
SF-425 Federal Financial Report 4040-0014, SF-425 Federal Financial Report 4040-0014
USDA/AMS
201901-0581-003CF
SF-425 Federal Financial Report
Historical Active
SF-425 Federal Financial Report 4040-0014
DOT/FAA
201901-2120-001CF
Aviation Research Grants Program
Historical Active
SF-425 Federal Financial Report 4040-0014
DOI/FWS
201807-1018-010CF
SF-425 Federal Financial Report usage for USFWS
Historical Active
SF-425 Federal Financial Report 4040-0014
USDA/RHS
201806-0575-030CF
SF-425 Federal Financial Report
Historical Active
SF-425 Federal Financial Report 4040-0014
USDA/RUS
201710-0572-035CF
Federal Financial Report
Historical Active
SF-425 Federal Financial Report 4040-0014
USDA/RBS
201802-0570-043CF
SF-425, “Federal Financial Report”
Historical Active
SF-425 Federal Financial Report 4040-0014
USDA/FS
201802-0596-013CF
Federal Financial Report (SF-425)
Historical Active
SF-425 Federal Financial Report 4040-0014
DOT/FMCSA
201809-2126-005CF
SF-425 Federal Financial Report
Historical Active
SF-425 Federal Financial Report 4040-0014
USDA/RHS
201810-0575-005CF
SF-425 Federal Financial Report
Historical Active
SF-425 Federal Financial Report 4040-0014
USDA/RUS
201804-0572-047CF
Financial Status Report (SF-425)
Historical Active
SF-425 Federal Financial Report 4040-0014, SF-425 Federal Financial Report 4040-0014
DOI/OSMRE
201605-1029-006CF
Request to use SF-425 - Federal Financial Report - Private Sector for OSMRE
Historical Active
SF-425 Federal Financial Report 4040-0014
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:
10/20/2015
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