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

Forms and Documents

Document Name	Status
Form HUD-52767 Application for the Resident Opportunities and Self Sufficiency (ROSS) Program Form and Instruction	Modified
Published FR Notice.pdf Supplementary Document	2011-06-21
83i_2577-0229 07-15-11 (2).doc Supporting Statement A	2011-08-11
83c for ROSS SC NOFA.doc Justification for No Material/Nonsubstantive Change	2009-04-09

IC Document Collections

IC ID	Document Title	Status
42121	Application for the Resident Opportunities and Self Sufficiency (ROSS) Program Form and Instruction	Modified

ICR Details

OMB Control No: 2577-0229	ICR Reference No: 201101-2577-001
Status: Historical Active	Previous ICR Reference No: 200904-2577-002
Agency/Subagency: HUD/PIH	Agency Tracking No: PRA-2010-035
Title: Application for the Resident Opportunities and Self Sufficiency (ROSS) Program
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 08/12/2011
	Date Received in OIRA: 04/05/2011
Terms of Clearance: OMB notes that thil collection was in violation of the Paperwork Reduction Act from April 1, 2011 until the date of this approval. Previous terms of clearance remain in effect. Finally, OMB notes that this should have been submitted as a Reinstatement without Change of a Previously Approved Collection.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2014	36 Months From Approved
Responses	650	0	0
Time Burden (Hours)	3,201	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Application for the ROSS grant program: Resident Service Delivery Models-Family, Resident Service Delivey Models-Elderly, Family Self-Sufficiency for Public Housing, Homeownership Supportive Services, and Neighborhood Networks.

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Authorizing Statute(s): PL: Pub.L. 105 - 276 112 Stat. 2461 Name of Law: Public Housing Reform Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 164	01/03/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 17663	03/30/2011
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Application for the Resident Opportunities and Self Sufficiency (ROSS) Program	HUD-2994-A, HUD-2991, 52753, 52755, SF424, SF424 Suppplement, 52767, HUD 52752, HUD 52754, HUD 2880, HuD 2990, HUD 96010, SF LLL, HUD-52769, HUD-52768, HUD-52767, HUD-2993	Public Housing Family Self-Sufficiency Funding Request Form ,   Acknowledgment of Application Receipt ,   Certification of Consistency with the Consolidated Plan ,   Grant Applicant Survey ,   Sample Contract Administrator Partnership Agreement ,   PHA FSS Request Form ,   ROSS ResCouncBoardElec ,   Cert. with Indian Hsng. Plan ,   Lis of Resid. Assoc. Supporting Nonprofit Applicants ,   Application for Federal Assistance ,   Survey on Ensuring Equal Opportunity for Applicants ,   Applicant/Recipient Disclosure/Update Report ,   Certification of Consistency with RC/EZ/EC-II Strategic ,   Disclosure of Lobbying Activities ,   Logic Model ,   Ross Service Coordinators- Funding Request ,   Ross Service Coordinators- Needs and Service Partners

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	650	0	0	0	0	650
Annual Time Burden (Hours)	3,201	0	0	0	-1,099	4,300
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: 15. This collection package is an extension of a previously approved collection. The burden hours previously reported were 10,458. There is a reduction of 6158 hours. The reduction in burden hours is attributed to the ROSS effort shifting from a direct service program to a program, which will fund the salary and administrative expenses for Service Coordinators. As a result, several existing forms are being removed: HUD-52751, HUD-52763, HUD-52764, HUD-52756, HUD-52757, HUD-424-CB, HUD-424-CBW, and HUD-27300. In addition, two new forms were added: HUD-52768 and HUD-52769. The burden hours were estimated by HUD staff that completed sample packages of forms.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 04/05/2011

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