Assisted Living Conversion Program (ALCP) and Emergency Capital Repair Program (ECRP)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form HUD 92047 Grant Agreement	Form and Instruction	Modified	Available
Form HUD 92046 Use Agreement	Form and Instruction	Modified	Available
Form HUD 424 CBW Grant Application Detailed Budget Worksheet	Form and Instruction	Modified	Available
Form HUD 424 CB Grant Application Detailed Budget	Form and Instruction	Modified	Available
Form HUD 27300 America's Affordable Communities Initiative	Form and Instruction	Modified	Available
Form HUD 92045 ALCP Application Summary Sheet	Form and Instruction	Modified	Available
Form SF-424-SUPP. Standard Form 424-SUPP	Form and Instruction	Modified	Available
Form SF-269 Standard Form 269	Form and Instruction	Modified	Available
Form HUD-2994-A You are our Client	Form and Instruction	Modified	Available
Form SF-LLL Standard Form LLL	Form and Instruction	Modified	Available
Form HUD-50080-ALCP HUD 50080-ALCP	Form and Instruction	Modified	Available
Form HUD-96010 Logic Model	Form and Instruction	Modified	Available
Form HUD-2530 HUD 2530	Form and Instruction	Modified	Available
Form HUD-96011 Third Party Documenation Fascsimile Transmittal	Form and Instruction	Modified	Available
Form HUD-2990-2991 HUD form 2990	Form and Instruction	Modified	Available
Form HUD-2880 HUD 2880	Form and Instruction	Modified	Available
Form SF-424 Standard Form SF-424	Form	Modified	Available
Form SF-425 Federal Financial Report	Form and Instruction	New	Available
Form 50080ercp ALCP Payment Voucher Emergency Capital Grant Program	Form	New	Available
FR-2502-0542.pdf	Supplementary Document	Uploaded 2013-03-07	Available
PLAW-106 - 113.pdf	Supplementary Document	Uploaded 2013-02-25	Available
2502-0542 PLAW-111-372.pdf	Supplementary Document	Uploaded 2013-02-25	Available
2502-0542 PLAW-106 - 74.pdf	Supplementary Document	Uploaded 2013-02-25	Available
5 CFR 5 105a.doc	Supplementary Document	Uploaded 2013-02-08	Available
Supporting_Statement_-_A2.doc	Supporting Statement A	Uploaded 2013-11-20	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
27327	Assisted Living Conversion Program (ALCP) and Emergency Capital Repair Program (ECRP)	Form and Instruction	Modified	Grant Agreement
27327	Assisted Living Conversion Program (ALCP) and Emergency Capital Repair Program (ECRP)	Form and Instruction	Modified	Use Agreement
27327	Assisted Living Conversion Program (ALCP) and Emergency Capital Repair Program (ECRP)	Form and Instruction	Modified	Grant Application Detailed Budget Worksheet
27327	Assisted Living Conversion Program (ALCP) and Emergency Capital Repair Program (ECRP)	Form and Instruction	Modified	Grant Application Detailed Budget
27327	Assisted Living Conversion Program (ALCP) and Emergency Capital Repair Program (ECRP)	Other-Certificaition	Modified
27327	Assisted Living Conversion Program (ALCP) and Emergency Capital Repair Program (ECRP)	Form and Instruction	Modified	America's Affordable Communities Initiative
27327	Assisted Living Conversion Program (ALCP) and Emergency Capital Repair Program (ECRP)	Form and Instruction	Modified	ALCP Application Summary Sheet
27327	Assisted Living Conversion Program (ALCP) and Emergency Capital Repair Program (ECRP)	Form and Instruction	Modified	Standard Form 424-SUPP
27327	Assisted Living Conversion Program (ALCP) and Emergency Capital Repair Program (ECRP)	Form and Instruction	Modified	Standard Form 269
27327	Assisted Living Conversion Program (ALCP) and Emergency Capital Repair Program (ECRP)	Form and Instruction	Modified	You are our Client
27327	Assisted Living Conversion Program (ALCP) and Emergency Capital Repair Program (ECRP)	Form and Instruction	Modified	Standard Form LLL
27327	Assisted Living Conversion Program (ALCP) and Emergency Capital Repair Program (ECRP)	Form and Instruction	Modified	HUD 50080-ALCP
27327	Assisted Living Conversion Program (ALCP) and Emergency Capital Repair Program (ECRP)	Form and Instruction	Modified	Logic Model
27327	Assisted Living Conversion Program (ALCP) and Emergency Capital Repair Program (ECRP)	Form and Instruction	Modified	HUD 2530
27327	Assisted Living Conversion Program (ALCP) and Emergency Capital Repair Program (ECRP)	Form and Instruction	Modified	Third Party Documenation Fascsimile Transmittal
27327	Assisted Living Conversion Program (ALCP) and Emergency Capital Repair Program (ECRP)	Form and Instruction	Modified	HUD form 2990
27327	Assisted Living Conversion Program (ALCP) and Emergency Capital Repair Program (ECRP)	Form and Instruction	Modified	HUD 2880
27327	Assisted Living Conversion Program (ALCP) and Emergency Capital Repair Program (ECRP)	Form	Modified	Standard Form SF-424
209384	Emergency Capital Repair Grant Program	Form and Instruction	New	Federal Financial Report
209384	Emergency Capital Repair Grant Program	Form	New	ALCP Payment Voucher Emergency Capital Grant Program

ICR Details

OMB Control No: 2502-0542	ICR Reference No: 201308-2502-006
Status: Historical Active	Previous ICR Reference No: 201301-2502-010
Agency/Subagency: HUD/OH	Agency Tracking No:
Title: Assisted Living Conversion Program (ALCP) and Emergency Capital Repair Program (ECRP)
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: 11/20/2013
Retrieve Notice of Action (NOA)	Date Received in OIRA: 08/23/2013
Terms of Clearance: HUD shall continue to accurately enter burden information.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2016	36 Months From Approved	11/30/2013
Responses	532	0	532
Time Burden (Hours)	805	0	805
Cost Burden (Dollars)	0	0	0

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Abstract: The Assisted Living Conversion Program (ALCP) provides funding for the physical costs of converting some or all of the units of an eligible multifamily development into an assisted living facility. Funding available through the Emergency Capital Repair Program (ECRP) provides funds for substantial capital repairs to eligible multifamily projects with elderly tenants that are needed to rehabilitate, modernize, or retrofit aging structure, common areas, or individual dwelling units.

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Authorizing Statute(s): US Code: 12 USC 1701Q-2 Name of Law: National Housing Act
  

Citations for New Statutory Requirements: None

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 4156	01/18/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 14324	03/05/2013
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Assisted Living Conversion Program (ALCP) and Emergency Capital Repair Program (ECRP)	HUD 424 CB, HUD-96011, HUD-2994-A, SF-424, SF-424-SUPP., SF-LLL, HUD-2880, HUD-2990-2991, HUD-2530, HUD-96010, HUD-50080-ALCP, SF-269, HUD 92045, HUD 424 CBW, HUD 92046, HUD 27300, HUD 92047	Standard Form SF-424 ,   HUD 2880 ,   HUD form 2990 ,   Third Party Documenation Fascsimile Transmittal ,   HUD 2530 ,   Logic Model ,   HUD 50080-ALCP ,   Standard Form LLL ,   You are our Client ,   Standard Form 269 ,   Standard Form 424-SUPP ,   ALCP Application Summary Sheet ,   America's Affordable Communities Initiative ,   Grant Application Detailed Budget ,   Grant Application Detailed Budget Worksheet ,   Use Agreement ,   Grant Agreement
Emergency Capital Repair Grant Program	SF-425, 50080ercp	ALCP Payment Voucher Emergency Capital Grant Program ,   Federal Financial Report

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ICR Summary of Burden

table that charts list 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	532	532	0	0	0	0
Annual Time Burden (Hours)	805	805	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The program has two sources of burden. ROCIS was updated to reflect that.

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Annual Cost to Federal Government: $28,611

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]? Yes

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Yes

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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: 08/23/2013

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