202601-0570-005CF RCF OMB: 4040-0005
OMB.report
OMB 4040-0005
RCF 202601-0570-005CF
( RCF Recertification )
Array
(
[refNbr] => 202601-0570-005CF
[obm] => 4040-0005
[icr] => 202509-4040-003
[status] => Active
[agency] => USDA/RBS
[title] => SF 424, Application for Federal Assistance
[typeRCF] => RCF Recertification
[oiraAction] => Approved
[oiraNOA] => 1599080
[termsOfClearance] =>
[previousRCF] => 202302-0570-025CF
[agencyTrackingNo] =>
[conclusionDate] => 2026-01-20
[dateReceived] => 2026-01-20
)
Document
View RCF
- OIRA Conclusion
RCF ID: 202601-0570-005CFPrevious RCF ID: 202302-0570-025CF
Status:
Active
Expiration Date: 01/31/2029
Agency/Subagency: USDA/RBSAgency Tracking No:
Host OMB Control No: 4040-0005Host ICR Reference No: 202509-4040-003
Title: SF 424, Application for Federal Assistance
Type of RCF: RCF Recertification
OIRA Conclusion Action: ApprovedConclusion Date:
01/20/2026
Retrieve Notice of Action (NOA)
Date Received in OIRA:
01/20/2026
Terms of Clearance:
Description of Agency Usage:
Used by Applicants in the pre-award phase as a required cover sheet for applications submitted for the HBIIP grants. The application is an official form required for all Federal grants and requests basic information about the applicant and the proposed project. This common form is submitted as part of the application. This form is associated with OMB Docket No. 0570-0072.
Authorizing Statute(s):
None
Annual Cost to Federal Government:
Agency Contact:
MaryPat Daskal 202 720-7853 marypat.daskal@wdc.usda.gov
Common Form Information Collections (IC) in this RCF:
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
SF-424 Individual Burden Estimate
100
100
0
Form
4040-0005
Application for Federal Assistance SF-424 Individual
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
100
0
0
0
0
Annual Time Burden (Hours)
100
100
0
0
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: