2013-17220. Agency Information Collection Activities; Submission to OMB for Review and Approval; Public Comment Request

AGENCY:

Electronic Government Office, HHS.

ACTION:

Notice.

SUMMARY:

In compliance with section 3507(a)(1)(D) of the Paperwork Reduction Act of 1995, the Electronic Government Office (EGOV), Department of Health and Human Services, has submitted an Information Collection Request (ICR), described below, to the Office of Management and Budget (OMB) for review and approval. The ICR is for reinstatement of a previously-approved information collection assigned OMB control number 4040-0003, which expired on November 30, 2011. The ICR also requests categorizing the form as a common form, meaning HHS will only request approval for its own use of the form rather than aggregating the burden estimate across all Federal Agencies as was done for previous actions on this OMB control number. Comments submitted during the first public review of this ICR will be provided to OMB. OMB will accept further comments from the public on this ICR during the review and approval period.

DATES:

Comments on the ICR must be received on or before August 19, 2013.

ADDRESSES:

Submit your comments to [e-mail] or via facsimile to [phone].

FOR FURTHER INFORMATION CONTACT:

Information Collection Clearance staff, [e-mail] or [phone].

SUPPLEMENTARY INFORMATION:

When submitting comments or requesting information, please include the OMB control number 4040-0003 and document identifier HHS-EGOV-16926-30D for reference.

Information Collection Request Title: SF-424 Application for Federal Assistance Short Form.

OMB No.: 4040-0003.

Abstract: The SF-424 Application for Federal Assistance Short Form is a common form used by Federal grant-making agencies for applicants to apply for Federal financial assistance.

Need and Proposed Use of the Information: The SF-424 Application for Federal Assistance Short Form is used by the public to apply for Federal financial assistance in the form of grants. These forms are submitted to the Federal grant-making agencies for evaluation and review.

Likely Respondents: Organizations and institutions seeking grants.

Burden Statement: Burden in this context means the time expended by persons to generate, maintain, retain, disclose or provide the information requested. This includes the time needed to review instructions, to develop, acquire, install and utilize technology and systems for the purpose of collecting, validating and verifying information, processing and maintaining information, and disclosing and providing information, to train personnel and to be able to respond to a collection of information, to search data sources, to complete and review the collection of information, and to transmit or otherwise disclose the information. The total annual burden hours estimated for this ICR are summarized in the table below.

HHS estimates that the SF-424 Application for Federal Assistance Short Form will take 1 hour to complete.

Once OMB approves the use of this common form, federal agencies may request OMB approval to use this common form without having to publish notices and request public comments for 60 and 30 days. Each agency must account for the burden associated with their use of the common form.

Total Estimated Annualized Burden—Hours

Form name	Number of respondents	Number of responses per respondent	Average burden per response (in hours)	Total burden hours
SF-424 Application for Federal Assistance	1	1	1	1
Total	1			1

Keith A. Tucker,

Information Collection Clearance Officer.