Information Collection

Continuum of Care Homeless Assistance Grant Application

IC 27416 under ICR 201204-2506-006 · OMB 2506-0112.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2506-0112 can be found here:

Documents and Forms

Document Name Document Type
Form HUD-2991 Continuum of Care Homeless Assistance Grant Application Form
Subpopulation Extrapolation Tool - Random Sample_v_7.22.08.xls Other-Extrapolation Tool
Subpopulation Extrapolation Tool - Stratified Sample_v_7.22.08.xls Other-Stratified Sample Extrapolatio
2008 HIC_v_7.22.08.xls Other-Spreadsheet
General Extrapolation Tool_v_7.22.08.xls Other-General Extrapolation tool
Project Application Data Elements_2012_Final.xlsx Other-Elements
HUD-2991 Cert of Consistency with the Consolidated Plan HUD 2991.pdf Form
HUD-2880 Applicant/Recipient Disclosure/Update Report HUD 2880.pdf Form
HUD-27300 Regulatory Barriers 27300.pdf Form
HUD-92041 Sponsor's Conflict of Interest Resolution 92041.pdf Form
screen shot of burden hours.docx Screen shot for burden hours IC Document
CoC Ex. 1 Application Data Elements_v3_4 10 09.doc Application Data Elements IC Document
CoC Ex. 2 Project Application Data Elements_v1_3 03 09.doc Project Application Data Elements IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Continuum of Care Homeless Assistance Grant Application	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 882.300(d)(1) 24 CFR 583.300(g)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HUD-2991	Cert of Consistency with the Consolidated Plan	HUD 2991.pdf	Yes	Yes	Fillable Fileable
Form	HUD-2880	Applicant/Recipient Disclosure/Update Report	HUD 2880.pdf	Yes	Yes	Fillable Fileable
Form	HUD-27300	Regulatory Barriers	27300.pdf	Yes	Yes	Fillable Fileable
Form	HUD-92041	Sponsor's Conflict of Interest Resolution	92041.pdf	Yes	Yes	Fillable Fileable
Other-Extrapolation Tool			Subpopulation Extrapolation Tool - Random Sample_v_7.22.08.xls	Yes	Yes	Fillable Fileable
Other-Stratified Sample Extrapolation Tool			Subpopulation Extrapolation Tool - Stratified Sample_v_7.22.08.xls	Yes	Yes	Fillable Fileable
Other-Spreadsheet			2008 HIC_v_7.22.08.xls	Yes	Yes	Fillable Fileable
Other-General Extrapolation tool			General Extrapolation Tool_v_7.22.08.xls	Yes	Yes	Fillable Fileable
Other-Elements			Project Application Data Elements_2012_Final.xlsx	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: 52,039	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	52,039	29,139	22,900
Annual IC Time Burden (Hours)	316,347	131,535	184,812
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Screen shot for burden hours	screen shot of burden hours.docx	05/21/2009
Application Data Elements	CoC Ex. 1 Application Data Elements_v3_4 10 09.doc	05/21/2009
Project Application Data Elements	CoC Ex. 2 Project Application Data Elements_v1_3 03 09.doc	05/21/2009

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.