Forms

Application Forms

• SF-424 Application for Federal Assistance [PDF - 163 KB] Exit Disclaimer: You Are Leaving www.ihs.gov 
• SF-424A Budget Information - Nonconstruction Programs [PDF - 1.5 MB] Exit Disclaimer: You Are Leaving www.ihs.gov 

Assurances

• SF-424B Non-construction Programs [PDF - 70 KB] Exit Disclaimer: You Are Leaving www.ihs.gov 
• HHS-690 Assurance of Compliance [PDF - 691 KB] Exit Disclaimer: You Are Leaving www.ihs.gov 

Certifications

• Disclosure of Lobbying Activities Form [PDF - 109 KB] Exit Disclaimer: You Are Leaving www.ihs.gov 
• Certification Regarding Lobbying, Fillable PDF [PDF - 61.5 KB] Exit Disclaimer: You Are Leaving www.ihs.gov 
• Debarment Certification (Primary) [PDF - 29 KB]
• Debarment Certification (Lower Tier) [PDF - 32 KB]
• Drug-free Certification [PDF - 38 KB]
• Environmental Tobacco Smoke [PDF - 25 KB]
• Maintenance of Effort Certification [PDF - 25 KB]

Federal Financial Report

• SF-425 Federal Financial Report, Fillable PDF [PDF - 3.1 MB] Exit Disclaimer: You Are Leaving www.ihs.gov 

Other Financial Forms

• SF-270 Request for Advance or Reimbursement [PDF - 66 KB] Exit Disclaimer: You Are Leaving www.ihs.gov 
  The SF-270 is a Fillable PDF form. After downloading it, click the Enable All Features button in the yellow toolbar to open the form fully.

Tangible Personal Property forms

These forms are found on the Grants.gov Web site. Exit Disclaimer: You Are Leaving www.ihs.gov 
The links below access the forms directly from the Grants.gov site.

• SF-428 Tangible Personal Property Report and Instructions [PDF - 53 KB] Exit Disclaimer: You Are Leaving www.ihs.gov 
• SF-428-A Annual Report [PDF - 95 KB] Exit Disclaimer: You Are Leaving www.ihs.gov 
• SF-428-B Final Report Form and Instructions [PDF - 54 KB] Exit Disclaimer: You Are Leaving www.ihs.gov 
• SF-428-C Disposition Request/Report [PDF - 54 KB] Exit Disclaimer: You Are Leaving www.ihs.gov 
• SF-428-S Supplemental Form and Instructions [PDF - 114 KB] Exit Disclaimer: You Are Leaving www.ihs.gov 

Real Property Forms

These forms are found on the Grants.gov Web site. Exit Disclaimer: You Are Leaving www.ihs.gov 
The links below access the forms directly from the Grants.gov site.

• Instructions for the SF-429 Real Property Status Report [PDF - 42 KB] Exit Disclaimer: You Are Leaving www.ihs.gov 
• SF-429 Real Property Status Report (Cover Page) [PDF - 49 KB] Exit Disclaimer: You Are Leaving www.ihs.gov 
• SF-429-A Real Property Status Report Attachment A (General Reporting) [PDF - 64 KB] Exit Disclaimer: You Are Leaving www.ihs.gov 
• SF-429-B Real Property Status Report Attachment B (Request to Acquire, Improve or Furnish) [PDF - 58 KB] Exit Disclaimer: You Are Leaving www.ihs.gov 
• SF-429-C Real Property Status Report Attachment C (Disposition or Encumbrance Request) [PDF - 60 KB] Exit Disclaimer: You Are Leaving www.ihs.gov 

Miscellaneous Forms

• Relinquishing Statement PHS 3734, Fillable PDF [PDF - 40 KB] Exit Disclaimer: You Are Leaving www.ihs.gov 
  Official Statement Relinquishing Interests and Rights in a Public Health Service Research Grant (PHS 3734)
• Project/Performance Site Location(s), Fillable PDF [PDF - 166 KB] Exit Disclaimer: You Are Leaving www.ihs.gov 
• Key Contacts Form, Fillable PDF [PDF - 41 KB] Exit Disclaimer: You Are Leaving www.ihs.gov