Document

Agency Information Collection Request. 60-Day Public Comment Request

In compliance with the requirement of the Paperwork Reduction Act of 1995, the Office of the Secretary (OS), Department of Health and Human Services, is publishing the following...

PDF version Source Record

Department of Health and Human Services

[Document Identifier: OS-4040-0005]

AGENCY:

Office of the Secretary, HHS.

ACTION:

Notice.

SUMMARY:

In compliance with the requirement of the Paperwork Reduction Act of 1995, the Office of the Secretary (OS), Department of Health and Human Services, is publishing the following summary of a proposed collection for public comment.

DATES:

Comments on the ICR must be received on or before September 8, 2025.

ADDRESSES:

Submit your comments to sagal.musa@hhs.gov or by calling 202-578-5441.

FOR FURTHER INFORMATION CONTACT:

When submitting comments or requesting information, please include the document identifier 4040-0005-60D and project title for reference, to Sagal Musa, email: sagal.musa@hhs.gov or call 202-578-5441, the Reports Clearance Officer.

SUPPLEMENTARY INFORMATION:

Interested persons are invited to send comments regarding this burden estimate or any other aspect of this collection of information, including any of the following subjects: (1) The necessity and utility of the proposed information collection for the proper performance of the agency's functions; (2) the accuracy of the estimated burden; (3) ways to enhance the quality, utility, and clarity of the information to be collected; and (4) the use of automated collection techniques or other forms of information technology to minimize the information collection burden.

Title of the Collection: Application for Federal Domestic Assistance—Individual.

Type of Collection: Extension.

OMB No.: 4040-0005.

Abstract: The Application for Federal Assistance—Individual form provides the Federal grant-making agencies an ( printed page 30647) alternative to the Standard Form 424 data set and form. Agencies may use Application for Federal Assistance—Individual form for grant programs not required to collect all the data that is required on the SF-424 core data set and form.

Type of Respondent: The Application for Federal Assistance—Individual form is used by organizations to apply for Federal financial assistance in the form of grants. This form is submitted to the Federal grant-making agencies for evaluation and review. This IC expires on February 26, 2026. Grants.gov seeks a three-year clearance of these collections.

Annualized Burden Hour Table
Forms (if necessary)	Respondents (if necessary)	Number of respondents	Number of responses per respondents	Average burden per response	Total burden hours
Application for Federal Assistance—Individual	Grant Applicants	5,403	1	1	5,403
Total		5,403	1	1	5,403

Catherine Howard,

Paperwork Reduction Act Reports Clearance Officer, Department of Health and Human Services, Office of the Secretary.

[FR Doc. 2025-12796 Filed 7-9-25; 8:45 am]

BILLING CODE 4151-AE-P

Legal Citation

Federal Register Citation

Use this for formal legal and research references to the published document.

90 FR 30646

Web Citation

Suggested Web Citation

Use this when citing the archival web version of the document.

“Agency Information Collection Request. 60-Day Public Comment Request,” thefederalregister.org (July 10, 2025), https://thefederalregister.org/documents/2025-12796/agency-information-collection-request-60-day-public-comment-request.