Grant Application for Housing for People Who Are Homeless and Addicted to Alcohol

ICR 200503-2506-001

OMB: 2506-0176

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
2506-0176 200503-2506-001
Historical Active
HUD/CPD
Grant Application for Housing for People Who Are Homeless and Addicted to Alcohol
New collection (Request for a new OMB Control Number)   No
Emergency 03/28/2005
Approved without change 03/25/2005
Retrieve Notice of Action (NOA) 03/07/2005
1) The Privacy Act notice in HUD-40112 will state "There is no personal information contained in this application. Information on actvities and expenditures of grant funds is public informa- tion and is generally available for disclosure. Recipients are responsible for ensuring confidentiality when disclosure is not required. 2) This form shall include page numbers like "1 of 6".
  Inventory as of this Action Requested Previously Approved
07/31/2005 07/31/2005
100 0 0
1,586 0 0
0 0 0

This information is necessary for applicants to be eligible for renewal under the Continuum of Care process once the terms of the grant have expired.

None
None


No

1
IC Title Form No. Form Name
Grant Application for Housing for People Who Are Homeless and Addicted to Alcohol HUD-96010, HUD-96011, HUD-27300, HUD-2991, HUD-40112, SF424, SF424A, SF424S

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 100 0 0 100 0 0
Annual Time Burden (Hours) 1,586 0 0 1,586 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
03/07/2005


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