Housing Choice Voucher Program

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 52681B HUD form 5268-1B/VMS	Form and Instruction	Unchanged	Available
Form HUD-52663 Requisition for Partial payment of Annual Contributions	Form and Instruction	Unchanged	Available
Form HUD 52530C Tenancy Addendum	Form and Instruction	Unchanged	Available
Form 52578B Statement of Family Responsibility	Form and Instruction	Unchanged	Available
Form HUD 5253A PBV HAP New Construction Part 2	Form and Instruction	Unchanged	Available
Form HUD 52530-A HAP New Construction Part 1	Form and Instruction	Unchanged	Repair queued
Form 52530-B Housing Hap part 1	Form and Instruction	Unchanged	Repair queued
Form HUD 52530-B Housing HAP part 2	Form and Instruction	Unchanged	Available
Form HUD 52681-b Voucher for Payment of Annual Contributions and Operating Statement	Form and Instruction	Unchanged	Repair queued
Form HUD 52681 Voucher for Payment of Annual Contributions and Operating Statement	Form and Instruction	Unchanged	Repair queued
Form HUD 52672 Supporting Data for Annual Contributions Estimates	Form and Instruction	Unchanged	Available
Form HUD 52667 Allowances for Tenant-Furnished Utilities and Other Services	Form and Instruction	Unchanged	Available
Form HUD 52665 Family Portability Information	Form and Instruction	Unchanged	Repair queued
Form HUD 52649 Statement of Homeowner Obligations Housing Choice Homeownership Voucher Program	Form and Instruction	Unchanged	Available
Form HUD 52646 Voucher	Form and Instruction	Unchanged	Available
Form HUD 52642-A Tenancy Addendum Manfactured Home Space Rental Section 8 Tenant-Based Assitance Housing Choice Voucher Program	Form and Instruction	Unchanged	Repair queued
Form HUD 52642 Housing Assitance Payments Contract Manufactured Home Space Rental	Form and Instruction	Unchanged	Available
Form HUD 52641-A Tenancy Addendum	Form and Instruction	Unchanged	Available
Form HUD 52641 Housing Assitance Payments Contract (HAP Contract)	Form and Instruction	Unchanged	Available
Form HUD 52580-A Inspection Form	Form and Instruction	Unchanged	Available
Form HUD52580 Inspection Checklist	Form and Instruction	Unchanged	Available
Form HUD 52531B Agreement to Enter Into Housing Assistance Payments Contract	Form and Instruction	Unchanged	Available
Form HUD 52531A Agreement to Enter Into Housing Assistance Payments Contract	Form and Instruction	Unchanged	Repair queued
Form HUD 52517 Request for Tenancy Approval	Form and Instruction	Unchanged	Repair queued
Form HUD52515 Funding Application-Section 8 Tenant-Based Assistnace Rental Voucher Program	Form and Instruction	Unchanged	Available
2577-0169 83-i.docx	Supporting Statement A	Uploaded 2014-07-22	Available
IPA 10-11-11.doc	Supplementary Document	Uploaded 2012-03-07	Repair queued
Published FR Notice.pdf	Supplementary Document	Uploaded 2012-02-28	Available
IPA 10-11-11.doc	Supplementary Document	Uploaded 2012-02-28	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
27839	Housing Choice Voucher Program	Form and Instruction	Unchanged	HUD form 5268-1B/VMS
27839	Housing Choice Voucher Program	Form and Instruction	Unchanged	Requisition for Partial payment of Annual Contributions
27839	Housing Choice Voucher Program	Form and Instruction	Unchanged	Tenancy Addendum
27839	Housing Choice Voucher Program	Form and Instruction	Unchanged	Statement of Family Responsibility
27839	Housing Choice Voucher Program	Form and Instruction	Unchanged	PBV HAP New Construction Part 2
27839	Housing Choice Voucher Program	Form and Instruction	Unchanged	HAP New Construction Part 1
27839	Housing Choice Voucher Program	Form and Instruction	Unchanged	Housing Hap part 1
27839	Housing Choice Voucher Program	Form and Instruction	Unchanged	Housing HAP part 2
27839	Housing Choice Voucher Program	Form and Instruction	Unchanged	Voucher for Payment of Annual Contributions and Operating Statement
27839	Housing Choice Voucher Program	Form and Instruction	Unchanged	Voucher for Payment of Annual Contributions and Operating Statement
27839	Housing Choice Voucher Program	Form and Instruction	Unchanged	Supporting Data for Annual Contributions Estimates
27839	Housing Choice Voucher Program	Form and Instruction	Unchanged	Allowances for Tenant-Furnished Utilities and Other Services
27839	Housing Choice Voucher Program	Form and Instruction	Unchanged	Family Portability Information
27839	Housing Choice Voucher Program	Form and Instruction	Unchanged	Statement of Homeowner Obligations Housing Choice Homeownership Voucher Program
27839	Housing Choice Voucher Program	Form and Instruction	Unchanged	Voucher
27839	Housing Choice Voucher Program	Form and Instruction	Unchanged	Tenancy Addendum Manfactured Home Space Rental Section 8 Tenant-Based Assitance Housing Choice Voucher Program
27839	Housing Choice Voucher Program	Form and Instruction	Unchanged	Housing Assitance Payments Contract Manufactured Home Space Rental
27839	Housing Choice Voucher Program	Form and Instruction	Unchanged	Tenancy Addendum
27839	Housing Choice Voucher Program	Form and Instruction	Unchanged	Housing Assitance Payments Contract (HAP Contract)
27839	Housing Choice Voucher Program	Form and Instruction	Unchanged	Inspection Form
27839	Housing Choice Voucher Program	Form and Instruction	Unchanged	Inspection Checklist
27839	Housing Choice Voucher Program	Form and Instruction	Unchanged	Agreement to Enter Into Housing Assistance Payments Contract
27839	Housing Choice Voucher Program	Form and Instruction	Unchanged	Agreement to Enter Into Housing Assistance Payments Contract
27839	Housing Choice Voucher Program	Form and Instruction	Unchanged	Request for Tenancy Approval
27839	Housing Choice Voucher Program	Form and Instruction	Unchanged	Funding Application-Section 8 Tenant-Based Assistnace Rental Voucher Program

ICR Details

OMB Control No: 2577-0169	ICR Reference No: 201407-2577-003
Status: Historical Active	Previous ICR Reference No: 201212-2577-003
Agency/Subagency: HUD/PIH	Agency Tracking No: 2577-0169
Title: Housing Choice Voucher Program
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/11/2014
Retrieve Notice of Action (NOA)	Date Received in OIRA: 08/06/2014
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2017	36 Months From Approved
Responses	3,039,017	0	0
Time Burden (Hours)	1,239,192	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Public housing agencies (PHA) apply for funding to assist very low-income families to lease or purchase housing. PHAs maintain records on participant eligibility, unit acceptability, lease and housing assistance payments, and budget and payment documentation. In some cases, PHAs voluntarily divest their voucher programs to a receiving PHA. PHAs may also project-base a portion of their vouchers or use their vouchers under the Homeownership Option.

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Authorizing Statute(s): US Code: 44 USC Chapter 35, as amended Name of Law: Section 3506 of the Paperwork Reduction Act of 1995
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
2577-AC83	Final or interim final rulemaking	79 FR 36146	06/25/2014

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 78292	12/16/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 13619	03/07/2012
Did the Agency receive public comments on this ICR? Yes

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

table that charts list of burden

IC Title	Form No.	Form Name
Housing Choice Voucher Program	HUD 52681-b, HUD 52530-A, HUD-52663, 52681B, HUD 52681, HUD52515, HUD 52517, HUD 52531A, HUD 52531B, HUD52580, HUD 52580-A, HUD 52641, HUD 52641-A, HUD 52530-B, HUD 52642, HUD 52665, HUD 52667, HUD 52672, HUD 52642-A, HUD 5253A, HUD 52649, HUD 52646, 52578B, HUD 52530C, 52530-B	Funding Application-Section 8 Tenant-Based Assistnace Rental Voucher Program ,   Request for Tenancy Approval ,   Agreement to Enter Into Housing Assistance Payments Contract ,   Agreement to Enter Into Housing Assistance Payments Contract ,   Inspection Checklist ,   Inspection Form ,   Housing Assitance Payments Contract (HAP Contract) ,   Tenancy Addendum ,   Housing Assitance Payments Contract Manufactured Home Space Rental ,   Tenancy Addendum Manfactured Home Space Rental Section 8 Tenant-Based Assitance Housing Choice Voucher Program ,   Voucher ,   Statement of Homeowner Obligations Housing Choice Homeownership Voucher Program ,   Family Portability Information ,   Allowances for Tenant-Furnished Utilities and Other Services ,   Supporting Data for Annual Contributions Estimates ,   Voucher for Payment of Annual Contributions and Operating Statement ,   Voucher for Payment of Annual Contributions and Operating Statement ,   Housing HAP part 2 ,   Housing Hap part 1 ,   HAP New Construction Part 1 ,   PBV HAP New Construction Part 2 ,   Statement of Family Responsibility ,   Tenancy Addendum ,   Requisition for Partial payment of Annual Contributions ,   HUD form 5268-1B/VMS

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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	3,039,017	0	0	1,063	0	3,037,954
Annual Time Burden (Hours)	1,239,192	0	0	744	0	1,238,448
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: No

Burden Reduction Due to:

Short Statement: Paperwork related to the proposed PBV rule and the reinstatement of one financial form (HUD-52663)

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Annual Cost to Federal Government: $457,500

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

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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: 08/06/2014

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