Agency Information Collection Request. 30-Day Public Comment Request

---
identifier: "/us/fr/2019-15389"
source: "fr"
legal_status: "authoritative_unofficial"
title: "Agency Information Collection Request. 30-Day Public Comment Request"
title_number: 0
title_name: "Federal Register"
section_number: "2019-15389"
section_name: "Agency Information Collection Request. 30-Day Public Comment Request"
positive_law: false
currency: "2019-07-19"
last_updated: "2019-07-19"
format_version: "1.1.0"
generator: "[email protected]"
agency: "Health and Human Services Department"
document_number: "2019-15389"
document_type: "notice"
publication_date: "2019-07-19"
agencies:
  - "Health and Human Services Department"
fr_citation: "84 FR 34904"
fr_volume: 84
docket_ids:
  - "Document Identifier: OS-4040-0005"
comments_close_date: "2019-08-19"
fr_action: "Notice."
---


#  Agency Information Collection Request. 30-Day Public Comment Request

**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 August 19, 2019.

**ADDRESSES:**

Submit your comments to *[email protected]* or via facsimile to (202) 395-5806.

**FOR FURTHER INFORMATION CONTACT:**

Ed Calimag, *[email protected]* or (202) 690-7569. When submitting comments or requesting information, please include the document identifier 4040-0005-30D and project title for reference.

**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 Collections:* Application for Federal 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 alternative to the Standard Form 424 data set and form. Agencies may use the 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. The IC expires on 10/31/2019. We are seeking an extension of this information collection and a three-year clearance.

| Forms | Number of | Number of | Average | Total |
| --- | --- | --- | --- | --- |
| Application for Federal Assistance—Individual | 0 | 1 | 1 | 0 |
| Total | 0 |  |  | 0 |

Terry Clark,

Office of the Secretary, Paperwork Reduction Act Reports Clearance Officer.