Application for Healthy Homes and Lead Hazard Control Grant Programs and Quality Assurance Plans

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form HUD 96009 Benchmark Standards (42 Months)	Form	Unchanged	Available
Form HUD 96008 Benchmark Standards (36 Months)	Form	Unchanged	Available
Form HUD 96013 Needs/Extent of the Problem	Form and Instruction	Unchanged	Repair queued
Form HUD 96011 Third Party Documentation	Form and Instruction	Unchanged	Available
Form HUD 96010 Logic Model	Form and Instruction	Unchanged	Available
Form SF LLL Disclosure of Lobbying Activities Required	Form and Instruction	Unchanged	Available
Form HUD 2994-A Client Comments and Suggestins	Form and Instruction	Unchanged	Available
Form HUD 2880 Disclosure and Update Report	Form and Instruction	Unchanged	Available
Form HUD 27300 America's Affordable Communities Initiative	Form and Instruction	Unchanged	Repair queued
Form HUD 27061 Race and Ethnic Data Reporting Form	Form and Instruction	Unchanged	Available
Form HUD 424 cbw Grant Application Detailed Budget Worksheet	Form and Instruction	Unchanged	Available
Form SF 424 Application for Federal Assistance	Form and Instruction	Unchanged	Repair queued
Form HUD 96015 Leveraging Resources	Form and Instruction	Unchanged	Available
Form HUD 96014 Soundness of Approach	Form and Instruction	Unchanged	Available
Form HUD 96012 Capacity of the Applicant and Relevant Organizational Experience	Form and Instruction	Unchanged	Repair queued
ICR 2539-0015 Renewal 4nov2014.doc	Supporting Statement A	Uploaded 2014-11-04	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
27731	Application for Healthy Homes and Lead Hazard Control Program Grants	Form	Unchanged	Benchmark Standards (42 Months)
27731	Application for Healthy Homes and Lead Hazard Control Program Grants	Form	Unchanged	Benchmark Standards (36 Months)
27731	Application for Healthy Homes and Lead Hazard Control Program Grants	Form and Instruction	Unchanged	Needs/Extent of the Problem
27731	Application for Healthy Homes and Lead Hazard Control Program Grants	Form and Instruction	Unchanged	Third Party Documentation
27731	Application for Healthy Homes and Lead Hazard Control Program Grants	Form and Instruction	Unchanged	Logic Model
27731	Application for Healthy Homes and Lead Hazard Control Program Grants	Form and Instruction	Unchanged	Disclosure of Lobbying Activities Required
27731	Application for Healthy Homes and Lead Hazard Control Program Grants	Form and Instruction	Unchanged	Client Comments and Suggestins
27731	Application for Healthy Homes and Lead Hazard Control Program Grants	Form and Instruction	Unchanged	Disclosure and Update Report
27731	Application for Healthy Homes and Lead Hazard Control Program Grants	Form and Instruction	Unchanged	America's Affordable Communities Initiative
27731	Application for Healthy Homes and Lead Hazard Control Program Grants	Form and Instruction	Unchanged	Race and Ethnic Data Reporting Form
27731	Application for Healthy Homes and Lead Hazard Control Program Grants	Form and Instruction	Unchanged	Grant Application Detailed Budget Worksheet
27731	Application for Healthy Homes and Lead Hazard Control Program Grants	Form and Instruction	Unchanged	Application for Federal Assistance
27731	Application for Healthy Homes and Lead Hazard Control Program Grants	Form and Instruction	Unchanged	Leveraging Resources
27731	Application for Healthy Homes and Lead Hazard Control Program Grants	Form and Instruction	Unchanged	Soundness of Approach
27731	Application for Healthy Homes and Lead Hazard Control Program Grants	Form and Instruction	Unchanged	Capacity of the Applicant and Relevant Organizational Experience
27731	Application for Healthy Homes and Lead Hazard Control Program Grants	Other-Survey	Unchanged

ICR Details

OMB Control No: 2539-0015	ICR Reference No: 201411-2539-001
Status: Historical Active	Previous ICR Reference No: 201110-2539-001
Agency/Subagency: HUD/OLBPPP	Agency Tracking No:
Title: Application for Healthy Homes and Lead Hazard Control Grant Programs and Quality Assurance Plans
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 without change	Conclusion Date: 01/22/2015
Retrieve Notice of Action (NOA)	Date Received in OIRA: 11/17/2014
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2018	36 Months From Approved	01/31/2015
Responses	330	0	330
Time Burden (Hours)	21,760	0	21,760
Cost Burden (Dollars)	0	0	0

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Abstract: This information collection is required in conjunction with the issuance of Notice of Funding Availability of approximately for Healthy Homes and Lead Hazard Control Programs that are authorized under Title X of the Housing and Community Development Act of 1992, Pub. L. 102-550, Section 1011, and other legislation. The quality Assurance Plan is obtained after the award of grants.

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Authorizing Statute(s): PL: Pub.L. 102 - 550 1011 Name of Law: Title X of the Housing and Community Development act of 1992
  

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:
	79 FR 52349	09/03/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 65696	11/05/2014
Did the Agency receive public comments on this ICR? No

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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
Application for Healthy Homes and Lead Hazard Control Program Grants	HUD 96012, HUD 27300, HUD 96015, HUD 27061, SF 424, HUD 2994-A, SF LLL, HUD 96010, HUD 96011, HUD 96014, HUD 424 cbw, HUD 2880, HUD 96013, HUD 96008, HUD 96009	Capacity of the Applicant and Relevant Organizational Experience ,   Soundness of Approach ,   Leveraging Resources ,   Application for Federal Assistance ,   Grant Application Detailed Budget Worksheet ,   Race and Ethnic Data Reporting Form ,   America's Affordable Communities Initiative ,   Disclosure and Update Report ,   Client Comments and Suggestins ,   Disclosure of Lobbying Activities Required ,   Logic Model ,   Third Party Documentation ,   Needs/Extent of the Problem ,   Benchmark Standards (36 Months) ,   Benchmark Standards (42 Months)

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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	330	330	0	0	0	0
Annual Time Burden (Hours)	21,760	21,760	0	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: $74,720

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: 11/17/2014

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