HHS Form 690 Assurance of Compliance: Filing and Submission

To fill out and submit HHS Form 690, complete a single page with your organization’s legal name and mailing address, have an authorized official sign and date it, and file it once — either electronically through the OCR Assurance of Compliance portal at ocrportal.hhs.gov or by mailing a signed hard copy to the HHS Office for Civil Rights in Washington, D.C. There is no fee, and the assurance stays on record for the entire period your organization receives HHS financial assistance, so you do not refile it with each new grant.¹²

What the Form Asks For

Form 690 is one page. The top block contains the assurance language itself; the bottom holds the fields you complete. There are five:

Name of Agency Receiving/Requesting Funding. Use the full legal name of your organization exactly as it appears in federal records. Inconsistencies between this name and the name on your grant application can slow processing.
Street Address, City, State, and Zip Code. Enter the mailing address where official correspondence about the assurance should go, usually your main administrative office.
Signature of Authorized Official. The signer must have legal authority to bind the organization — typically a CEO, president, executive director, or equivalent.
Name and Title of Authorized Official. Print the signer’s name and organizational title below the signature.
Date. The date the authorized official signs.

That is the whole form. The current version (OMB Control Number 0945-0008) does not include fields for an Employer Identification Number or National Provider Identifier, even though older guidance documents sometimes reference them.¹ Those numbers appear on other application paperwork if a grant requires them.

What the Signature Commits Your Organization To

The signature is the substantive part of the form. It is not a receipt. It legally commits the organization — and its successors, transferees, and assignees — to operate every federally assisted program in compliance with five federal nondiscrimination statutes for the full period during which HHS assistance is provided.¹ Those statutes are:

Title VI of the Civil Rights Act of 1964 (42 U.S.C. § 2000d) — race, color, national origin.³
Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. § 794) — disability.⁴
Title IX of the Education Amendments of 1972 (20 U.S.C. § 1681) — sex, in education programs including medical, nursing, and healthcare training programs funded by HHS.⁵
Age Discrimination Act of 1975 (42 U.S.C. § 6101) — age.⁶
Section 1557 of the Affordable Care Act (42 U.S.C. § 18116) — race, color, national origin (including limited English proficiency), age, disability, and sex (including pregnancy, sexual orientation, and gender identity) in health programs.¹

Make sure the authorized official has actually read that assurance language before signing. An executive who signs without understanding the commitment leaves the organization exposed if a compliance question comes up later.

Submitting Online Through the OCR Portal

The fastest route is the OCR Assurance of Compliance portal at ocrportal.hhs.gov/ocr/aoc/instruction.jsf. The portal asks for the same information as the paper form: agency name, the authorized official’s name and title (with a salutation dropdown), and the organization’s full mailing address including country.⁷ In place of a wet signature, the authorized official checks a box confirming their identity and authority to bind the organization, then clicks Submit. You get an immediate electronic record of the filing.

Submitting by Mail

If you prefer paper, download the form from hhs.gov, complete and sign it, and mail it to:¹

U.S. Department of Health & Human Services
Office for Civil Rights
200 Independence Ave., S.W.
Room 509F
Washington, D.C. 20201

Certified mail is worth the small extra cost because it gives you a delivery record. If a grant office later asks whether your assurance is on file and OCR’s records lag, the tracking number proves you filed. Keep a photocopy of the signed form in your permanent administrative files no matter which submission method you use.

Other Ways to Get a Copy of the Form

Besides downloading from hhs.gov or using the online portal, you can request the form by emailing GrantsInfo@nih.gov or calling 301-435-0714.²

Who Actually Has to File

Every domestic organization that receives federal financial assistance from HHS must have a completed Form 690 on file with OCR before funding can be awarded. Federal financial assistance covers grants, loans, federal contracts (other than insurance or guaranty contracts), donations of federal property, detail of federal personnel, and other arrangements whose purpose is providing assistance.⁸ Hospitals, community health centers, state and local health departments, social service agencies, research institutions, and universities receiving HHS grants all fall inside that scope.

The obligation also reaches downstream. Consortium participants, sub-grantees, and contractors under grants must file their own Form 690, and the direct recipient is responsible for confirming that each downstream organization has done so.² A small clinic receiving a portion of a state-level HHS grant is bound by the same filing requirement as the state agency that passed the money through.

Filing is a one-time event. You file once for the organization and it stays on record; new grant applications do not require a new form.² A change in organizational leadership does not reset the obligation, because the assurance binds successors and assignees for the full period of assistance.¹

What Happens After You File

Once the form is on record with OCR, you generally will not hear anything about it unless a compliance question arises. The assurance remains in effect for the entire period your organization receives HHS financial assistance. There is no annual renewal and no requirement to refile when applying for a new HHS-funded program.

The commitment itself is not passive. By signing, your organization accepted a material condition of continued funding. OCR conducts periodic compliance reviews and can open an investigation whenever a complaint, report, or other information suggests possible noncompliance.⁹ In practical terms, that means maintaining internal policies aligned with the five statutes on the form, training staff on nondiscrimination obligations, and keeping records showing your programs are accessible to the populations you serve.

1
U.S. Department of Health and Human Services. HHS Form 690 – Assurance of Compliance
2
National Institutes of Health. NIH Grants Policy Statement – 4.1.2 Civil Rights Protections
3
Office of the Law Revision Counsel. 42 USC 2000d
4
Office of the Law Revision Counsel. 29 US Code 794
5
Office of the Law Revision Counsel. 20 USC 1681
6
Office of the Law Revision Counsel. 42 Code 76
7
U.S. Department of Health & Human Services. Assurance of Compliance
8
HHS.gov. Federal Financial Assistance
9
eCFR. 45 CFR Part 80 – Nondiscrimination Under Programs Receiving Federal Assistance