Standardized form for Race and Ethnicity

Forms and Documents

Document Name	Status
Form HUD-27061 Standardized form for "Race and Ethnic Data Collection" Form and Instruction	Unchanged
Supporting Statement 2535-0113 Race and Etnic form.docx Supporting Statement A	2015-03-11

IC Document Collections

IC ID	Document Title	Status
27690	Standardized form for "Race and Ethnic Data Collection" Form and Instruction	Unchanged

ICR Details

OMB Control No: 2535-0113	ICR Reference No: 201412-2535-001
Status: Historical Inactive	Previous ICR Reference No: 201306-2535-001
Agency/Subagency: HUD/OA	Agency Tracking No:
Title: Standardized form for Race and Ethnicity
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Improperly submitted	Conclusion Date: 06/23/2015
	Date Received in OIRA: 03/19/2015
Terms of Clearance: Previous TOC remain in effect: HUD has approval for one year under the condition that it evaluates: Whether the form can be made more dynamic (e.g., for the “Other multiple race combinations” line, the fillable fileable PDF does not allow respondents to create additional lines to enter more than one race combination, for the “Other multiple race combinations” line, the PDF does not allow respondents to write text to describe the combination) Whether the form can be made simpler (e.g., instructions ask respondents to calculate percentages for the other multiple race combinations, but not for the other categories. Understanding that the combinations need to be greater than one percent, the precise listing may not be necessary) Whether the burden estimates are accurate (e.g., is the burden one hour or 1.15 hours per response, are there really 4.2 million applicants for HUD funding and organizations that tabulate race/ethnicity data, what is the staff time expended to compile and analyze this data)

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		36 Months From Approved
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: All HUD program offices use this form when collecting information concerning the race and ethnicity of the populations intended to benefit from HUD funding as required by Title IV of the Civil Rights Act of 1964.

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Authorizing Statute(s): None

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 5761	12/02/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 14148	03/18/2015
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
Standardized form for "Race and Ethnic Data Collection"	HUD-27061	Race and Ethnic Data Reporting Form

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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: $0

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: 03/19/2015

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