HUD 52756 Program Staffing

ROSS
Chart A: PROGRAM STAFFING

U.S. DEPARTMENT OF HOUSING
AND URBAN DEVELOPMENT
OFFICE OF PUBLIC AND INDIAN HOUSING

OMB Approval No. 2577-0229
Expiration Date: 02/28/2007

SAVE

Applicant Name: ______________________________________

Instructions for completing this form: Space is provided below for applicants to provide information about key staff, residents you plan to hire, the roles contractors
will play, and the activities and responsibilities of the applicant’s contract administrator. All applicants must complete this form. Applicants that are not required to
have a contract administrator do not need to complete Section IV of this form.
Grant to which the applicant is applying:
_____ RSDM-Family _____ RSDM-Elderly _____ Homeownership Supportive Services _____ Neighborhood Networks _____ PH Family Self Sufficiency

I.

APPLICANT STAFF

Name of Staff Person

Organization and Position

Activity in Grant Program

1

Percent of Time
on Grant

Cost to Grant

form HUD-52756 (3/2004)

OMB Approval No. 2577-0229
Expiration Date: 02/28/2007

II.

RESIDENT STAFF (NOT APPLICABLE TO
FSS APPLICANTS)

Name of Staff Person

Organization and Position

Activity in Grant Program

2

Percent of Time
on Grant

Cost to Grant

form HUD-52756 (3/2004)

III.CONTRACTOR/CONSULTANT ROLE
(Not applicable to FSS applicants)
Type of Contractor to be Solicited*

Activity in Grant Program

Estimated Cost to Grant
Program

*NOTE: Contractors must be procured according to 24 CFR parts 84.41-84.48 or 24 CFR part 85.36

IV.CONTRACT ADMINISTRATOR
Name of Organization

Areas of Responsibility/Oversight

Estimated Cost to Grant
Program

Public reporting burden for the collection of information is estimated to average two hours per response. This includes the time for collecting, reviewing, and reporting
the data. The information will be used for the ROSS grant. Response to this request for information is required in order to receive the benefits to be derived. This
agency may not collect this information, and you are not required to complete this form unless it displays a currently valid OMB control number.
3

form HUD-52756 (3/2004)