27054 LOCCS Voice Response System Acess Auth Form

OMB Approval No. 2535-0102

U.S. Department of Housing
and Urban Development

LOCCS
Voice Response System
Access Authorization Form

(exp. 11/30/2016)

See Instructions, Public Burden, and Privacy Act statements on back before completing this form
This form is to be approved by the recipient’s
(or grantee’s) chief executive officer. For
new users, reinstate users, and resend
user ID, retain a copy and send a notarized
original to your HUD Program Office for
review.

The Program Office will forward the original form to:
U.S. Dept. of Housing and Urban Development
Chief Financial Officer, FYM
Attention: User Support Branch
PO Box 23774
Washington, DC 20026-3774

1. Type of Function (mark one)
1
New User
2
Reinstate User

5
Add New Program Area or Tax ID
6
Change Tax ID
3
Terminate User
7
Change Address
4
Reset Password for Active Users
8
Resend User ID
9
Name Change
3. Authorized User’s Name (last, first, mi) Print or Type
Title (mandatory)

Complete Mailing Address

For overnight delivery send to:
U.S. Dept. of Housing and Urban Development
Chief Financial Officer, FYM
Attention: User Support Branch
451 7th Street SW, Room 3114
Washington, DC 20410

2a. User ID (please leave blank)
(CFO USE ONLY)

2b. Social Security Number (SSN)
(mandatory)

Office Telephone Number
(include area code)

E-Mail Address

4. Recipient Organization for which Authority is being Requested
Tax ID

Organization’s Name

Tax ID

Organization’s Name

Tax ID

Organization’s Name

5a. LOCCS Program Area

5c. Q = Query Only
D = Project Drawdown

5b. Program Name

6. Authorized User’s Signature

Date (mm/dd/yyyy)

I authorize the person identified above to access LOCCS via the Voice Response System.
7. Approving Official’s Name (last, first, mi) Print or Type

Office Telephone Number
(include area code)

Title

Social Security Number (mandatory)

Complete Mailing Address

E-Mail Address

Approving Official’s Signature

Date (mm/dd/yyyy)

8. Notary (must be different from user
and approving official) Seal, Signature, and
Date Notarized (mm/dd/yyyy)

Office Telephone Number (include area code)

9. Program Office Point of Contact’s Name (last, first, mi) Print or Type

E-Mail Address

Title

Date (mm/dd/yyyy)

Program Office Point of Contact’s Signature

Warning: HUD will prosecute false claims and statements. Conviction may result in criminal and/or civil penalties. (18 U.S.C. 1001, 1010, 1012; 31 U.S.C. 3729, 3802)
Previous editions are obsolete.

Page 1 of 1

Form HUD-27054 (11/2013)

Public reporting burden for this collection of information is estimated to average 10 minutes per response, including the time for reviewing instructions,
searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. This agency
may not collect this information, and you are not required to complete this form, unless it displays a currently valid OMB control number.
HUD implemented the Line of Credit Control System/Voice Response System (LOCCS/VRS) to process requests for payments to grantees. Grant
recipients fill out a voucher form for the applicable HUD program with all the necessary information prior to making a telephone call using a touch tone
telephone to initiate the drawdown process. The grantee will be prompted for entering the information and for confirming information that is spoken back
by the VRS simulated voice. This information is required to obtain benefits under the U.S. Housing Act of 1937, as amended. The information requested
does not lend itself to confidentiality.
Privacy Act Statement: Public Law 97-255, Financial Integrity Act, 31 U.S.C. 3512, authorizes the Department of Housing and Urban Development
(HUD) to collect all the information which will be used by HUD to protect disbursement data from fraudulent actions. The Housing and Community
Development Act of 1987, 42 U.S.C.3543 authorizes HUD to collect the SSN. The purpose of the data is to safeguard the Line of Credit Control System
(LOCCS) from unauthorized access. The data are used to ensure that individuals who no longer require access to LOCCS have their access capability
promptly deleted. Provision of the SSN is mandatory. HUD uses it as a unique identifier for safeguarding the LOCCS from unauthorized access. This
information will not be otherwise disclosed or released outside of HUD, except as permitted or required by law. Failure to provide the information
requested on the form may delay the processing of your approval for access to LOCCS.

Instructions for the
LOCCS Voice Response Access Authorization Form
1.

Type of Function:
(1) New User: User does not currently have a LOCCS user
ID. Form must be notarized with original signatures.
(2) Reinstate User: Used to reinstate the user's access
authorization in LOCCS. Form must be notarized with original
signatures.
(3) Terminate User: Used to immediately terminate the
user's access authorization in LOCCS.

4. Recipient Organization for which authority is being
requested. This will identify the organization the user will be
representing. Enter the organization's Tax ID and organization
name.
5. Program Authority. Identify the HUD program areas this user
will be authorized to access for the recipient organization and
then enter the corresponding code(s)/name(s). See
http://portal.hud.gov/hudportal/documents/huddoc?id=prgareas.pdf

a. Enter the 3 or 4-character LOCCS Program Area.
(4) Reset Password for Active Users: A temporary
password will be mailed back to the user to inform him/her of
the reset password's value. The user will be required to
change the password on the next access to LOCCS.
(5) Add New Program Area or Tax ID: User has a current
User ID and will be increasing access capability.
(6) Change Tax ID: User has a current ID and will be
changing the Tax ID. This function is not to be used to
change approving official, or substitute a user. Contact
Program Office for procedures.
(7) Change Address: User is changing the current mailing
address.
(8) Resend User ID. User has no knowledge of existing
User ID.
(9) Name Change. User is requesting their name to be
changed.
2. a. User ID: This block will be filled in by the User Support
Branch.
b. Social Security Number. Mandatory. Used to preclude
duplicate issuance of authorization for the same person. See
the Privacy Act Statement above. [Do not use Federal Tax
ID Number]

b. Enter the Program Name.
c. Enter "Q" for Query only access or "D" for Project Drawdown
access. Users who select Project Drawdown access will
automatically receive Query access.
6. Signature/Date. The signature of the user requesting access
And the date (mm/dd/yyyy) this authorization was signed.
7. Approval. All fields are mandatory.
Enter the name, office telephone number, title, social
social security number, office address, signature and date of
the approving official representing the grantee. Approving
officials cannot approve themselves for access to the system,
and must be the user’s supervisor.
8. Notary. Must be different from user and approving official.
The official who notarizes the form shall include his/her seal,
signature, and date (mm/dd/yyyy). Notary should notarize both
signatures. Notary is only required for new user and reinstate
user.
9. Program Office Validation. The Program Office must
validate that the grantee is the correct official accessing the
grant. The Program Official shall include his/her name,
office telephone number, title, e-mail address, signature,
and date (mm/dd/yyyy).

3. User Information: All fields are mandatory. Failure to
enter any of these fields will cause the HUD-27054 to be
rejected. Enter the user's last name, first name, and middle
initial. Enter the user's office phone number. Enter user's
mailing address, city, state and zip code. Enter user’s e-mail
address.
Previous editions are obsolete.

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Form HUD-27054 (11/2013)