Information Collection

Homeless Providers Grant and Per Diem Program

IC 28735 under ICR 201305-2900-016 · OMB 2900-0554.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0554 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 10-0361-TA Homeless Providers Grant and Per Diem Program	Form and Instruction
2900-0554 Homeless-grants.gov-PD CvrLtr-TOC-Instructions_2013.pdf www.grants.gov	Instruction
2900-0554 PDO Second Submission Instructions_2013.pdf www.grants.gov	Instruction
VA Form 10-0361 PDO Section A Instr. 3-2013 (2).pdf www1.va.gov/homeless/page.cfm?pg=3	Instruction
10-0361-TA Homeless Providers Grant and Per Diem Program Technical VA Form 10-0361-TA 3-2013 (1).pdf www1.va.gov/homeless/page.cfm?pg=3	Form and Instruction
10-0361-CG Homeless Providers Grant and Per Diem Program Captial Gr VA Form 10-0361-CG-3-2013.pdf www1.va.gov/homeless/page.cfm?pg=3	Form and Instruction
10-0361-SN Homeless Providers Grant and Per Diem Program Special Ne VA Form 10-0361-SN 3-2013.pdf www1.va.gov/homeless/page.cfm?pg=3	Form and Instruction
10-0361-PDO Homeless Provider Grant and Per Diem Program - Per Diem 2900-0554 PDO Second Submission Application_2013.pdf www.grants.gov	Form

IC Title:

Homeless Providers Grant and Per Diem Program

Agency IC Tracking Number:

2900-0554

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 38 CFR 61.0-61.82

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 and Instruction	10-0361-TA	Homeless Providers Grant and Per Diem Program Technical Assistance Application	VA Form 10-0361-TA 3-2013 (1).pdf	http://www1.va.gov/homeless/page.cfm?pg=3	Yes	No	Fillable Printable
Form and Instruction	10-0361-CG	Homeless Providers Grant and Per Diem Program Captial Grant Application	VA Form 10-0361-CG-3-2013.pdf	http://www1.va.gov/homeless/page.cfm?pg=3	Yes	No	Fillable Printable
Form and Instruction	10-0361-SN	Homeless Providers Grant and Per Diem Program Special Needs Application	VA Form 10-0361-SN 3-2013.pdf	http://www1.va.gov/homeless/page.cfm?pg=3	Yes	No	Fillable Printable
Instruction			2900-0554 Homeless-grants.gov-PD CvrLtr-TOC-Instructions_2013.pdf	http://www.grants.gov	Yes	No	Fillable Fileable
Form	10-0361-PDO	Homeless Provider Grant and Per Diem Program - Per Diem Only Application	2900-0554 PDO Second Submission Application_2013.pdf	http://www.grants.gov	Yes	Yes	Fillable Printable
Instruction			2900-0554 PDO Second Submission Instructions_2013.pdf	http://www.grants.gov	Yes	No	Fillable Fileable
Instruction			VA Form 10-0361 PDO Section A Instr. 3-2013 (2).pdf	http://www1.va.gov/homeless/page.cfm?pg=3	Yes	No	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 785

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	785	-230	1,015
Annual IC Time Burden (Hours)	12,340	-2,000	14,340
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.