Supplement to Application for Federally Assisted Housing

Forms and Documents

Document Name	Status
Form HUD-92006 Supplement to Application for Federally Assisted Housing Form and Instruction	Modified
42USC13643.txt Supplementary Document	2012-10-02
42USC13604.txt Supplementary Document	2012-10-02
Supporting Statement - A (10-1012).doc Supporting Statement A	2012-10-02

IC Document Collections

IC ID	Document Title	Status
189133	Supplement to Application for Federally Assisted Housing Form and Instruction	Modified

ICR Details

OMB Control No: 2502-0581	ICR Reference No: 201204-2502-004
Status: Historical Active	Previous ICR Reference No: 200905-2502-002
Agency/Subagency: HUD/OH	Agency Tracking No:
Title: Supplement to Application for Federally Assisted Housing
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 11/21/2012
	Date Received in OIRA: 06/19/2012
Terms of Clearance: As shown to the changes made to this collection, HUD shall account for the cost burden of this collection.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2015	36 Months From Approved	11/30/2012
Responses	364,782	0	552,708
Time Burden (Hours)	91,196	0	138,177
Cost Burden (Dollars)	36,478	0	0

---

Abstract: Section 644 of the Housing and Community Development Act of 1992 (42 U.S.C. 13604) imposed on HUD the obligation to require housing providers participating in HUD's assisted housing programs to provide any individual or family applying for occupancy in HUD-assisted housing with the option to include in the application for occupancy the name, address, telephone number, and other relevant information of a family member, friend, or person associated with a social, health, advocacy, or similar organization. The objective of providing such information, if this information is provided, and if the applicant becomes a tenant, is to facilitate contact by the housing provider with the person or organization identified by the tenant, to assist in providing any the delivery of services or special care to the tenant and assist with resolving any tenancy issues arising during the tenancy of such tenant. This supplemental application information is to be maintained by the housing provider and maintained as confidential information.

---

Authorizing Statute(s): US Code: 42 USC 13604 Name of Law: Housing and Community Development Act of 1992
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 14	01/23/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 35705	06/14/2012
Did the Agency receive public comments on this ICR? Yes

---

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

IC Title	Form No.	Form Name
Supplement to Application for Federally Assisted Housing	HUD-92006	SUPPLEMENT TO APPLICATION FOR FEDERALLY ASSISTED HOUSING

---

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	364,782	552,708	0	0	-187,926	0
Annual Time Burden (Hours)	91,196	138,177	0	0	-46,981	0
Annual Cost Burden (Dollars)	36,478	0	0	36,478	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: There is no change in program requirements, the statutory requirement is a long-standing one. HUD made the determination to help ensure compliance with Section 644 through utilization of a standard form that requires housing providers to give to each applicant for occupancy a form that notifies the applicant of his or her option to provide the information specified in section 644, and provides for the submission of the information. Initially when the form was first distributed, all households were contacted and provided with a copy of the form to complete at their option. Now going forward, owner/agents will only give new admissions the form. So there has been a decrease overall, after the first round of forms were completed.

---

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

---

Common Form ICR:  No

---

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: 06/19/2012

---