Fillable Form Requirements May2018 (Department of Health and Human Services)

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Form Requirements May2018 (Department of Health and Human Services)

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04/2018
Form Requirements
Instructions
Grantors are requested to submit this form to Grants.gov when you submit the initial document at Federal Register with
information you have at the time. You can submit this updated form once your requirements are ready. Grants.gov form
development will begin once you provide complete requirements. Please submit this form for each new or modified form.
For New Form, please complete all applicable sections. For Modified Form, please complete sections by specifying
requested changes. Please be as specific and accurate as possible. Errors and changes to requirements outlined can
significantly delay the forms development process. Grants.gov encourages you to provide visual mock-ups of their
requested new and modified forms. Multiple attachments may be submitted, including form illustrations that are hand-
drawn.
1. Contact Information
Date Submitted:
1.1 *Requesting Agency/Sub-Agency:
1.2 *Point Of Contact:
1.3 *Phone Number:
1.3.1 Extension:
1.4 Email Address:
2. Form Request Details
New Form
Modification to an existing form
2.1.1 Proposed Version #:
2.3 *Form Name:
2.4 *Has the form been approved by OMB?
Yes
No
If Yes:
2.4.1 OMB Control Number:
2.4.2 OMB Expiration Date:
If No:
2.4.3 Estimated OMB Clearance Date:
2.5 *Estimated date of Production usage for this updated form:
2.6 Federal Registration Citation Number
60 days:
30 days:
2.7 Pick form family/families to which this form belongs (select all that apply):
SF-424
R&R
SF-424 Individual
SF-424 Mandatory
SF-424 Short Organization
2.2 *Brief Summary of Changes:
Submit by Email
Form Requirements
04/2018
3.1 Form Mock-up
3.2 Burden Statement
3. Form Mock-up and Burden Statement
4. * Form Instructions (Please use the following template to create detailed form instructions, then attach using Add
Attachments button: https://www.grants.gov/documents/19/217976/Federal_Agency_Form_Instructions_Template.docx)
5. Other Related Forms
6. Potential Use by Other Agencies/Sub Agencies
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Form Requirements
04/2018
7. Form Details
a. Field Label Name
b. Min Length/
Value
c. Max Length/
Value
d. Required
e. Help Tip
f. Business Rules/
Comments
10
ex: Federal Award Identifier
0
25
Enter the award number
previously assigned by the
Federal agency, if any.
Required if
ApplicationType =
Continuation, or Revision
8. Additional Business Rules (ex. 'Hide section 3, 4, and 5 when Applicant Type is Individual')
9. General Information
x
x
x
x
x
x
x
x
x
x
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Form Requirements May2018 (Department of Health and Human Services)

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Completed 1 February 2021

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