Jobs Plus Pilot Program

Forms and Documents

Document Name	Status
Form HUD-242 CBW Jobs Plus Pilot Program Form and Instruction	New
Published 30-day FR Notice.pdf Supplementary Document	2014-08-26
83-i-8 26 14.doc Supporting Statement A	2014-08-26
IPA Template.doc Supplementary Document	2014-08-19

IC Document Collections

IC ID	Document Title	Status
212823	Jobs Plus Pilot Program Form and Instruction	New

ICR Details

OMB Control No: 2577-0281	ICR Reference No: 201408-2577-003
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HUD/PIH	Agency Tracking No: 2577-NEW
Title: Jobs Plus Pilot Program
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  Yes
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/01/2014
	Date Received in OIRA: 09/02/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2017	36 Months From Approved
Responses	125	0	0
Time Burden (Hours)	8,959	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The information is required to allow HUD to conduct a competition to award and obligate Jobs Plus grant funds in accordance with the FY 2014 Appropriations Act, which permits HUD to use up to $15M of the appropriation for Jobs Plus Initiative

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Authorizing Statute(s): US Code: 44 USC Chapter 35 as amended Name of Law: Section 3507 of the Paperwork Reduction Act of 1995
  

Citations for New Statutory Requirements: US Code: 9 USC 1437q Name of Law: U.S. Housing Act of 1937

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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:
	79 FR 31963	06/03/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 49794	08/22/2014
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Jobs Plus Pilot Program	HUD-424-CB, SF-424, HUD 50144, SF-LLL, HUD-96011, HUD-242 CBW, HUD-424CBW-I, HUD-2880, HUD-2993	Grant Application Detailed Budget Worksheet ,   Grant Application Detailed Budget ,   Application for Federal Assistance ,   Instructions for Completing the Grant Application Detailed Budget Worksheet ,   Disclosure of Lobbying Activities ,   Application/Recipient Disclosure/Update Report ,   Acknowledgment of Application Receipt ,   Facsimile Transmittal ,   Jobs Plus Summary Budget

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ICR Summary 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	125	0	125	0	0	0
Annual Time Burden (Hours)	8,959	0	8,959	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $384,499

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:  Yes

Description/Changes for Common Form Usage:  The Jobs Plus Pilot Program Information Collection represents a new information request. The OMB approval number for this collection is pending. The information provided by the eligible applicants will be reviewed and evaluated by HUD. The information to be collected by HUD will be used to preliminarily rate applications, to determine eligibility for the Jobs Plus Pilot Grant Competition and to establish grant amounts. The Jobs Plus Pilot Grant Competition Application will be used to determine eligibility and funding for recipients. Respondents of this information collection will be public housing agencies. Forms for this information collection are under development, however it is anticipated that applicants will provide quantitative and qualitative data as well as narrative information for evaluation.

Approved RCFs using this ICR

Agency/Sub Agency	RCF ID	RCF Title	RCF Status	IC Title

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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: 09/02/2014

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