Information Collection

Application for displacement/relocation assistance for person

IC 27392 under ICR 201110-2506-003 · OMB 2506-0016.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2506-0016 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form HUD-40054 Application for displacement/relocation assistance for person	Form
HUD-40054 Residential Claim for Moving and Related Expenses 40054.pdf	Form
HUD-40055 Claim for Actual Reasonable Moving and Related Expenses- 40055.pdf	Form
HUD-40056 Claim for Fixed Payment in Lieu of Payment for Actual No 40056.pdf	Form
HUD-40057 Claim for Replacement Housing Payment for 180-Day Homeoo 40057.pdf	Form
HUD-40058 Claim for Rental Assistance or Down Payment Assistance ( 40058.pdf	Form
HUD-40061 Selection of Most Representative Comparable Replacement 40061.pdf	Form
HUD-40072 Claim for Rental of Purchase Assistance 40072.pdf	Form and Instruction
HUD 40030 Claim for Temporary Relocation 40030 Claim for Temporary Relocation.doc	Form and Instruction
HUD 40058-S Claim for Rental Assistance or Down payment Assistance 40058-S.pdf	Form and Instruction

IC Title:

Application for displacement/relocation assistance for person

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 49 CFR 24 24 CFR 42.1

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-40054	Residential Claim for Moving and Related Expenses	40054.pdf	Yes	No	Fillable Printable
Form	HUD-40055	Claim for Actual Reasonable Moving and Related Expenses-Nonresidential	40055.pdf	Yes	No	Fillable Printable
Form	HUD-40056	Claim for Fixed Payment in Lieu of Payment for Actual Nonresdidential Moving and Related Expenses	40056.pdf	Yes	No	Fillable Printable
Form	HUD-40057	Claim for Replacement Housing Payment for 180-Day Homeoowner-Occupant (49 CFR 24.401)	40057.pdf	Yes	No	Fillable Printable
Form	HUD-40058	Claim for Rental Assistance or Down Payment Assistance (49 CFR 24.402 and 24.401 (f))	40058.pdf	Yes	No	Fillable Printable
Form	HUD-40061	Selection of Most Representative Comparable Replacement Dwelling	40061.pdf	Yes	No	Fillable Printable
Form and Instruction	HUD-40072	Claim for Rental of Purchase Assistance	40072.pdf	Yes	No	Fillable Printable
Form and Instruction	HUD 40030	Claim for Temporary Relocation	40030 Claim for Temporary Relocation.doc	Yes	No	Fillable Fileable
Form and Instruction	HUD 40058-S	Claim for Rental Assistance or Down payment Assistance	40058-S.pdf	No		Fillable Printable

Line of Business: Community and Social Services

Subfunction: Homeownership Promotion

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 37,800

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	61,800	61,800
Annual IC Time Burden (Hours)	56,000	56,000
Annual IC Cost Burden (Dollars)	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.