Certification of Domestic Violence, Dating Violence, or Stalking

Implementation of the Violence Against Women and Department of Justice Reauthorization Act of 2005

OMB: 2577-0249

IC ID: 46037

Information Collection (IC) Details

View Information Collection (IC)

Certification of Domestic Violence, Dating Violence, or Stalking
 
No New
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction HUD-XXX Certification of Domestic Violence, Dating Violence, or Stalking VAWA form.doc No   Fillable Printable

Community and Social Services Community and Regional Development

 

200 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 200 200 0 0 0 0
Annual IC Time Burden (Hours) 200 200 0 0 0 0
Annual IC Cost Burden (Dollars) 4,800 4,800 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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