Information Collection

HUD-Administered Small Cities Program Performance Assessment Report

IC 27395 under ICR 201111-2506-004 · OMB 2506-0020.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2506-0020 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form HUD-4052 Instructions for Completing the CDBG Small Cities Performance Assessment Report HUD-Administered Small Cities Program Performance Assessment Report	Form
HUD-4052 Instructions for Completing the CDBG Small Cities Perfor 4052r.pdf	Form

IC Title:

HUD-Administered Small Cities Program Performance Assessment Report

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 570.420

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
Form	HUD-4052				Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 40

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	40	-25	65
Annual IC Time Burden (Hours)	160	-100	260
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.

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