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View ICR - OIRA Conclusion

OMB Control No: 4040-0014	ICR Reference No: 202401-1505-001CF
Status: Active	Previous ICR Reference No:
Agency/Subagency: TREAS/DO	Agency Tracking No:
Title: SF 425 - Federal Financial Report
Type of Information Collection: RCF New	Common Form ICR:
Type of Review Request:
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/25/2024
	Date Received in OIRA: 01/19/2024
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2025
Responses	138	0	0
Time Burden (Hours)	138	0	0
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Change Due to Agency Discretion
Annual Number of Responses	138	138
Annual Time Burden (Hours)	138	138
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: Treasury is requesting approval for usage of the SF 425 in conjunction with the new SSBCI Technical Assistance Grant Program.

Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods?

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

Agency Contact: Jamie Lipsey 202 604-6413 jamie.lipsey2@treasury.gov

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