SF-424 Mandatory

ICR 202509-4040-004

OMB: 4040-0020

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Unchanged
Supporting Statement A
2025-10-01
IC Document Collections
IC ID
Document
Title
Status
238521 Unchanged
ICR Details
4040-0020 202509-4040-004
Received in OIRA 202211-4040-003
EGOV
SF-424 Mandatory
Extension without change of a currently approved collection   Yes
Regular 11/14/2025
  Requested Previously Approved
36 Months From Approved 02/28/2026
5,761 5,761
5,761 5,761
0 0

The SF-424 Mandatory Form provides the Federal grant-making agencies an alternative to the Standard Form 424 data set and form. Agencies may use the SF-424 Mandatory Form for grant programs not required to collect all the data that is required on the SF-424 core data set and form.

PL: Pub.L. 106 - 107 468 Name of Law: Federal Financial Assistance Management Improvement Act of 1999
   PL: Pub.L. 109 - 282 2590 Name of Law: Federal Accountability and Transparency Act of 2006
  
None

Not associated with rulemaking

  90 FR 30647 07/10/2025
90 FR 44832 09/17/2025
No

1
IC Title Form No. Form Name
SF-424 Mandatory 4040-0002 Application for Federal Assistance - SF-424 Mandatory

  Total Request 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 5,761 5,761 0 0 0 0
Annual Time Burden (Hours) 5,761 5,761 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$224,679
No
    No
    No
No
No
No
No
Sagal Musa 202 205-2634 sagal.musa@hhs.gov

  Yes
 
Agency/Sub Agency RCF ID RCF Title RCF Status IC Title

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
11/14/2025


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