Information Collection

Jobs Plus Pilot Program

IC 212823 under ICR 201408-2577-003 · OMB 2577-0281.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2577-0281 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form HUD-242 CBW Jobs Plus Pilot Program	Form and Instruction
HUD-424-CB Grant Application Detailed Budget HUD-424-CB.pdf	Form and Instruction
SF-424 Application for Federal Assistance SF424.pdf	Form and Instruction
HUD 50144 Jobs Plus Summary Budget HUD-50144 Jobs Plus Summary Budget.xls	Form and Instruction
HUD-424CBW-I Instructions for Completing the Grant Application Detail HUD-424CBW-I.doc	Form and Instruction
SF-LLL Disclosure of Lobbying Activities SF-LLL.pdf	Form and Instruction
HUD-2880 Application/Recipient Disclosure/Update Report HUD-2880.pdf	Form and Instruction
HUD-2993 Acknowledgment of Application Receipt HUD-2993.pdf	Form and Instruction
HUD-96011 Facsimile Transmittal HUD-96011.pdf	Form and Instruction
HUD-242 CBW Grant Application Detailed Budget Worksheet HUD 424-cbw.xls	Form and Instruction

IC Title:

Jobs Plus Pilot Program

Agency IC Tracking Number:

2577-NEW

Is this a Common Form? Yes

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	HUD-242 CBW	Grant Application Detailed Budget Worksheet	HUD 424-cbw.xls	Yes	Yes	Fillable Printable
Form and Instruction	HUD-424-CB	Grant Application Detailed Budget	HUD-424-CB.pdf	Yes	Yes	Fillable Printable
Form and Instruction	SF-424	Application for Federal Assistance	SF424.pdf	Yes	Yes	Fillable Printable
Form and Instruction	HUD-424CBW-I	Instructions for Completing the Grant Application Detailed Budget Worksheet	HUD-424CBW-I.doc	Yes	Yes	Fillable Fileable
Form and Instruction	SF-LLL	Disclosure of Lobbying Activities	SF-LLL.pdf	Yes	Yes	Fillable Fileable Signable
Form and Instruction	HUD-2880	Application/Recipient Disclosure/Update Report	HUD-2880.pdf	Yes	Yes	Fillable Fileable Signable
Form and Instruction	HUD-2993	Acknowledgment of Application Receipt	HUD-2993.pdf	Yes	Yes	Fillable Fileable Signable
Form and Instruction	HUD-96011	Facsimile Transmittal	HUD-96011.pdf	Yes	Yes	Fillable Printable
Form and Instruction	HUD 50144	Jobs Plus Summary Budget	HUD-50144 Jobs Plus Summary Budget.xls	Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 125

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	125	125
Annual IC Time Burden (Hours)	8,959	8,959
Annual IC Cost Burden (Dollars)	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.