Information Collection

Required Screens for the Physical Assessment Subsystem (PASS) Exigent Health & Safety (EH&S) Reporting Application

IC 27931 under ICR 201012-2577-004 · OMB 2577-0241.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2577-0241 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
EHS_Input Screens.doc	Other-screen shot of imput screen
Exhibit C.doc Exhibit C copy of MB Disclosure	IC Document

IC Title:

Required Screens for the Physical Assessment Subsystem (PASS) Exigent Health & Safety (EH&S) Reporting Application

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 24 CFR part 5 subpart G 24 CFR 902 subpart B (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-screen shot of imput screen			EHS_Input Screens.doc		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Homeownership Promotion

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,263

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,263	97	1,166
Annual IC Time Burden (Hours)	334	-157	491
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Exhibit C copy of MB Disclosure	Exhibit C.doc	09/13/2007

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