Information Collection

Brownfields Economic Development Initiative (BEDI) Grant Application

IC 27456 under ICR 200711-2506-001 · OMB 2506-0153.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2506-0153 can be found here:

Documents and Forms

Document Name Document Type
Form HUD-40122 Brownfields Economic Development Initiative (BEDI) Grant Application Form and Instruction
HUD-40122 Sec. 10 Loan Guarantee Certification 40122.pdf Form and Instruction
HUD-40123 Brownfields Economic Development Application 40123.pdf Form and Instruction
SF-424 Applicaiton for Federal Assistance sf424.doc Form and Instruction
SF-424S Survey on Ensuring Equal Opportunity for Applicants sf424sup.pdf Form and Instruction
SF-LLL Disclosure of Lobbying Activities sflllin.pdf Form and Instruction
HUD-424-B Applicant Assurance and Certification 424-b.pdf Form and Instruction
HUD-2880 Applicant/Recipient Disclusre/Update Report 2880.doc Form and Instruction
HUD-96010-I Logic Model 96010.pdf Form and Instruction
HUD-2993 Acknowledgement of Application 2993.pdf Form and Instruction
HUD-2990 Certificaiton of Consistency with the RC/EZ/EC Strategic 2990.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Brownfields Economic Development Initiative (BEDI) Grant Application	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 570.703 24 CFR 570.208

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	HUD-40122	Sec. 10 Loan Guarantee Certification	40122.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	HUD-40123	Brownfields Economic Development Application	40123.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	SF-424	Applicaiton for Federal Assistance	sf424.doc	Yes	Yes	Fillable Fileable
Form and Instruction	SF-424S	Survey on Ensuring Equal Opportunity for Applicants	sf424sup.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	SF-LLL	Disclosure of Lobbying Activities	sflllin.pdf	Yes	Yes	Fillable Printable
Form and Instruction	HUD-424-B	Applicant Assurance and Certification	424-b.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	HUD-2880	Applicant/Recipient Disclusre/Update Report	2880.doc	Yes	Yes	Fillable Fileable
Form and Instruction	HUD-96010-I	Logic Model	96010.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	HUD-2993	Acknowledgement of Application	2993.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	HUD-2990	Certificaiton of Consistency with the RC/EZ/EC Strategic Plan	2990.pdf	Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	2,000	2,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.