Application for the Resident Opportunities and Self Sufficiency (ROSS) Program

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form HUD 27300 Removal of Regulatory	Form and Instruction	Modified	Available
Form HUD 96010 Logic Model	Form and Instruction	Modified	Available
Form SF LLL Disclosure of Lobbying Activities	Form and Instruction	Modified	Available
Form HuD 2990 Certification of Consistency with RC/EZ/EC-II Strategic	Form and Instruction	Modified	Available
Form HUD 2880 Applicant/Recipient Disclosure/Update Report	Form and Instruction	Modified	Available
Form HUD 424 cbw Grant Application Detailed Budget Worksheet	Form and Instruction	Modified	Available
Form HUD 424 cb Grant Application Detailed Budget	Form and Instruction	Modified	Available
Form SF424 Suppplement Survey on Ensuring Equal Opportunity for Applicants	Form and Instruction	Modified	Available
Form SF424 Application for Federal Assistance	Form and Instruction	Modified	Available
Form HUD 52756 Program Staffing	Form and Instruction	Modified	Repair queued
Form HUD 52754 Lis of Resid. Assoc. Supporting Nonprofit Applicants	Form and Instruction	Modified	Available
Form HUD 52752 Cert. with Indian Hsng. Plan	Form and Instruction	Modified	Available
Form 52763 ROSS Sample Work Plan RSDM Family	Form and Instruction	Modified	Available
Form 52757 ROSS ChartBAppAdminTrackRec	Form and Instruction	Modified	Available
Form 52753 ROSS ResCouncBoardElec	Form and Instruction	Modified	Available
Form 52767 PHA FSS Request Form	Form and Instruction	Modified	Available
Form HUD-52751 Ross Fund Fact Sheet	Form and Instruction	Modified	Available
Form 52755 Sample Contract Administrator Partnership Agreement	Form and Instruction	Modified	Available
ICR_2577-0229.doc	Supporting Statement A	Uploaded 0000-00-00	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
42121	Application for the Resident Opportunities and Self Sufficiency (ROSS) Program	Form and Instruction	Modified	Removal of Regulatory
42121	Application for the Resident Opportunities and Self Sufficiency (ROSS) Program	Form and Instruction	Modified	Logic Model
42121	Application for the Resident Opportunities and Self Sufficiency (ROSS) Program	Form and Instruction	Modified	Disclosure of Lobbying Activities
42121	Application for the Resident Opportunities and Self Sufficiency (ROSS) Program	Other-Certification	Modified
42121	Application for the Resident Opportunities and Self Sufficiency (ROSS) Program	Form and Instruction	Modified	Certification of Consistency with RC/EZ/EC-II Strategic
42121	Application for the Resident Opportunities and Self Sufficiency (ROSS) Program	Form and Instruction	Modified	Applicant/Recipient Disclosure/Update Report
42121	Application for the Resident Opportunities and Self Sufficiency (ROSS) Program	Form and Instruction	Modified	Grant Application Detailed Budget Worksheet
42121	Application for the Resident Opportunities and Self Sufficiency (ROSS) Program	Form and Instruction	Modified	Grant Application Detailed Budget
42121	Application for the Resident Opportunities and Self Sufficiency (ROSS) Program	Form and Instruction	Modified	Survey on Ensuring Equal Opportunity for Applicants
42121	Application for the Resident Opportunities and Self Sufficiency (ROSS) Program	Form and Instruction	Modified	Application for Federal Assistance
42121	Application for the Resident Opportunities and Self Sufficiency (ROSS) Program	Form and Instruction	Modified	Program Staffing
42121	Application for the Resident Opportunities and Self Sufficiency (ROSS) Program	Form and Instruction	Modified	Lis of Resid. Assoc. Supporting Nonprofit Applicants
42121	Application for the Resident Opportunities and Self Sufficiency (ROSS) Program	Form and Instruction	Modified	Cert. with Indian Hsng. Plan
42121	Application for the Resident Opportunities and Self Sufficiency (ROSS) Program	Form and Instruction	Modified	ROSS Sample Work Plan RSDM Family
42121	Application for the Resident Opportunities and Self Sufficiency (ROSS) Program	Form and Instruction	Modified	ROSS ChartBAppAdminTrackRec
42121	Application for the Resident Opportunities and Self Sufficiency (ROSS) Program	Form and Instruction	Modified	ROSS ResCouncBoardElec
42121	Application for the Resident Opportunities and Self Sufficiency (ROSS) Program	Form and Instruction	Modified	PHA FSS Request Form
42121	Application for the Resident Opportunities and Self Sufficiency (ROSS) Program	Form and Instruction	Modified	Ross Fund Fact Sheet
42121	Application for the Resident Opportunities and Self Sufficiency (ROSS) Program	Form and Instruction	Modified	Sample Contract Administrator Partnership Agreement

ICR Details

OMB Control No: 2577-0229	ICR Reference No: 200702-2577-001
Status: Historical Active	Previous ICR Reference No: 200609-2577-001
Agency/Subagency: HUD/PIH	Agency Tracking No:
Title: Application for the Resident Opportunities and Self Sufficiency (ROSS) Program
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/18/2007
Retrieve Notice of Action (NOA)	Date Received in OIRA: 02/15/2007
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2010	36 Months From Approved	05/31/2007
Responses	650	0	850
Time Burden (Hours)	10,458	0	41,643
Cost Burden (Dollars)	0	0	0

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Abstract: Application for the ROSS grant program: Resident Service Delivery Models-Family, Resident Service Delivey Models-Elderly, Family Self-Sufficiency for Public Housing, Homeownership Supportive Services, and Neighborhood Networks.

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Authorizing Statute(s): PL: Pub.L. 105 - 276 112 Stat. 2461 Name of Law: Public Housing Reform Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	71 FR 191	10/03/2006
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 30	02/14/2007
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Application for the Resident Opportunities and Self Sufficiency (ROSS) Program	HUD-52751, 52753, 52755, 52757, SF424, SF424 Suppplement, 52763, HUD 424 cb, 52767, HUD 52752, HUD 52754, HUD 52756, HUD 424 cbw, HUD 2880, HuD 2990, HUD 96010, HUD 27300, SF LLL	Sample Contract Administrator Partnership Agreement ,   Ross Fund Fact Sheet ,   PHA FSS Request Form ,   ROSS ResCouncBoardElec ,   ROSS ChartBAppAdminTrackRec ,   ROSS Sample Work Plan RSDM Family ,   Cert. with Indian Hsng. Plan ,   Lis of Resid. Assoc. Supporting Nonprofit Applicants ,   Program Staffing ,   Application for Federal Assistance ,   Survey on Ensuring Equal Opportunity for Applicants ,   Grant Application Detailed Budget ,   Grant Application Detailed Budget Worksheet ,   Applicant/Recipient Disclosure/Update Report ,   Certification of Consistency with RC/EZ/EC-II Strategic ,   Disclosure of Lobbying Activities ,   Logic Model ,   Removal of Regulatory

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ICR Summary of Burden

table that charts list of burden

	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	650	850	0	0	-200	0
Annual Time Burden (Hours)	10,458	41,643	0	-25,921	-5,264	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Changing Forms

Short Statement: The burden discrease is due to the elimination of several forms used in prior years.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 02/15/2007

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