Information Collection

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

IC 42121 under ICR 200707-2577-002 · OMB 2577-0229.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2577-0229 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 52767 Application for the Resident Opportunities and Self Sufficiency (ROSS) Program	Form and Instruction
2991.pdf	Other-Certification
52755 Sample Contract Administrator Partnership Agreement Sample Contract Administrator Partnership Agreement.pdf	Form and Instruction
HUD-52751 Ross Fund Fact Sheet 52751.pdf	Form and Instruction
52767 PHA FSS Request Form 52767.pdf	Form and Instruction
52753 ROSS ResCouncBoardElec 52753 ROSS ResCouncBoardElec.rtf	Form and Instruction
52757 ROSS ChartBAppAdminTrackRec 52757 ROSS ChartB-AppAdminTrackRec.rtf	Form and Instruction
52763 ROSS Sample Work Plan RSDM Family 52763 ROSS Sample Work Plan.RSDM Family.doc	Form and Instruction
HUD 52752 Cert. with Indian Hsng. Plan hud-52752.pdf	Form and Instruction
HUD 52754 Lis of Resid. Assoc. Supporting Nonprofit Applicants hud-52754.pdf	Form and Instruction
HUD 52756 Program Staffing hud-52756.pdf	Form and Instruction
SF424 Application for Federal Assistance sf424.doc	Form and Instruction
SF424 Suppplement Survey on Ensuring Equal Opportunity for Applicants sf424sup.doc	Form and Instruction
HUD 424 cb Grant Application Detailed Budget 424-cb.xls	Form and Instruction
HUD 424 cbw Grant Application Detailed Budget Worksheet 424-cbw.xls	Form and Instruction
HUD 2880 Applicant/Recipient Disclosure/Update Report 2880.doc	Form and Instruction
HuD 2990 Certification of Consistency with RC/EZ/EC-II Strategic 2990.pdf	Form and Instruction
SF LLL Disclosure of Lobbying Activities SF LLL.pdf	Form and Instruction
HUD 96010 Logic Model 96010.pdf	Form and Instruction
HUD 27300 Removal of Regulatory 27300.doc	Form and Instruction
HUD 52766 Neighborhood Networks Sample Business Plan 52766.pdf	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

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

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 24 CFR 538

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	52767	PHA FSS Request Form	52767.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	52755	Sample Contract Administrator Partnership Agreement	Sample Contract Administrator Partnership Agreement.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	HUD-52751	Ross Fund Fact Sheet	52751.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	HUD 96010	Logic Model	96010.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	HUD 27300	Removal of Regulatory	27300.doc	Yes	Yes	Fillable Fileable
Form and Instruction	HUD 52766	Neighborhood Networks Sample Business Plan	52766.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	HUD 424 cbw	Grant Application Detailed Budget Worksheet	424-cbw.xls	Yes	Yes	Fillable Fileable
Form and Instruction	HUD 2880	Applicant/Recipient Disclosure/Update Report	2880.doc	Yes	Yes	Fillable Fileable
Form and Instruction	HuD 2990	Certification of Consistency with RC/EZ/EC-II Strategic	2990.pdf	Yes	Yes	Fillable Fileable
Other-Certification			2991.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	SF LLL	Disclosure of Lobbying Activities	SF LLL.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	52753	ROSS ResCouncBoardElec	52753 ROSS ResCouncBoardElec.rtf	Yes	Yes	Fillable Fileable
Form and Instruction	52757	ROSS ChartBAppAdminTrackRec	52757 ROSS ChartB-AppAdminTrackRec.rtf	Yes	Yes	Fillable Fileable
Form and Instruction	52763	ROSS Sample Work Plan RSDM Family	52763 ROSS Sample Work Plan.RSDM Family.doc	Yes	Yes	Fillable Fileable
Form and Instruction	HUD 52752	Cert. with Indian Hsng. Plan	hud-52752.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	HUD 52754	Lis of Resid. Assoc. Supporting Nonprofit Applicants	hud-52754.pdf	Yes	Yes	Fillable Printable
Form and Instruction	HUD 52756	Program Staffing	hud-52756.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	SF424	Application for Federal Assistance	sf424.doc	Yes	Yes	Fillable Fileable
Form and Instruction	SF424 Suppplement	Survey on Ensuring Equal Opportunity for Applicants	sf424sup.doc	Yes	Yes	Fillable Fileable
Form and Instruction	HUD 424 cb	Grant Application Detailed Budget	424-cb.xls	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Community and Social Services

Subfunction: Homeownership Promotion

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 650

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	650	650
Annual IC Time Burden (Hours)	10,458	10,458
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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