Information Collection

Congregate Housing Services Program

IC 27226 under ICR 201106-2502-001 · OMB 2502-0485.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2502-0485 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form HUD-90198 Congregate Housing Services Program	Form
HUD-90198 Payment Voucher HUD-90198.pdf	Form
HUD-91180-A Summary Budget Grantee HUD-91180-a.pdf	Form
SF-269 Financial Status Report sf269.pdf	Form
HUD 91178A Annual Program Budget Grantee HUD-91178-a.pdf	Form
HUD 90006 Annual Reporting Form 90006.pdf	Form and Instruction

IC Title:

Congregate Housing Services 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 700.155(d)

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	HUD-90198	Payment Voucher	HUD-90198.pdf	No		Fillable Printable
Form	HUD-91180-A	Summary Budget Grantee	HUD-91180-a.pdf	No		Fillable Printable
Form	SF-269	Financial Status Report	sf269.pdf	No		Fillable Printable
Form	HUD 91178A	Annual Program Budget Grantee	HUD-91178-a.pdf	No		Fillable Printable
Form and Instruction	HUD 90006	Annual Reporting Form	90006.pdf	Yes	No	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Homeownership Promotion

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 55

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 75 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	440	-64	504
Annual IC Time Burden (Hours)	688	-415	1,103
Annual IC Cost Burden (Dollars)	0	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.