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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

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:

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 %

	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

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.