SF-424 Individual

Forms and Documents

Document Name	Status
Form 4040-0005 NEA SF-424 Individual Burden Estimate Form	Modified
Form 4040-0005 HHS SF-424 Individual Burden Estimate Form	New
Form 4040-0005 NEH SF-424 Individual Burden Estimate Form	New
Form 4040-0005 USDA SF-424 Individual Burden Estimate Form	New
Form 4040-0005 USAID Form	Modified
Form 4040-0005 NEH Form	Modified
Form 4040-0005 DOC Form	Modified
Form 4040-0005 NEA Form	Modified
Individual_Supporting Statement2008.doc Supporting Statement A	2008-09-30

IC Document Collections

IC ID	Document Title	Status
35967	NEA SF-424 Individual Burden Estimate Form	Modified
186774	HHS SF-424 Individual Burden Estimate Form	New
186773	NEH SF-424 Individual Burden Estimate Form	New
186772	USDA SF-424 Individual Burden Estimate Form	New
179800	USAID Form	Modified
179799	NEH Form	Modified
179798	DOC Form	Modified
179797	NEA Form	Modified

ICR Details

OMB Control No: 4040-0005	ICR Reference No: 200809-4040-001
Status: Historical Active	Previous ICR Reference No: 200704-4040-002
Agency/Subagency: EGOV	Agency Tracking No:
Title: SF-424 Individual
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/20/2008
	Date Received in OIRA: 09/30/2008
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2011	36 Months From Approved	11/30/2008
Responses	15,141	0	6,949
Time Burden (Hours)	6,627	0	2,895
Cost Burden (Dollars)	0	0	0

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Abstract: The SF-424 Individualform supports the streamlined application requirements for individuals and reduces the administrative burden with a standard government-wide application form.

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Authorizing Statute(s): US Code: 31 USC 6301-6308 Name of Law: null
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 36328	06/26/2008
30-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 56829	09/30/2008
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 8

IC Title	Form No.	Form Name
NEA SF-424 Individual Burden Estimate	4040-0005	SF-424 Individual
USDA SF-424 Individual Burden Estimate	4040-0005	SF-424 Individual
NEH SF-424 Individual Burden Estimate	4040-0005	SF-424 Individual
HHS SF-424 Individual Burden Estimate	4040-0005	SF-424 Individual
NEA	4040-0005	SF-424 Individual
DOC	4040-0005	SF-424 Individual
NEH	4040-0005	SF-424 Individual
USAID	4040-0005	SF-424 Individual

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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	15,141	6,949	0	8,192	0	0
Annual Time Burden (Hours)	6,627	2,895	0	3,732	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: No

Burden Reduction Due to:

Short Statement: This is a revision of a currently approved collection. We are deleting the Social Security number field and revising the instructions to reflect this change. Burden change is due to agency estimates collected for this renewal.

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Annual Cost to Federal Government: $107,925

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]? 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

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Common Form ICR:  No

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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: 09/30/2008

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