Application for the Resident Opportunities and Self Sufficiency (ROSS) Program

Forms and Documents

Document Name	Status
Form HUD-52769 - Origin Application for the Resident Opportunities and Self Sufficiency (ROSS) Program Form and Instruction	Modified
IPA Forms.doc Supplementary Document	2015-01-15
Published 60-day FR Notoce.pdf Supplementary Document	2015-01-15
2577-0229 SS HUD Response to OMB Comments.doc Supporting Statement A	2015-06-08

IC Document Collections

IC ID	Document Title	Status
42121	Application for the Resident Opportunities and Self Sufficiency (ROSS) Program Form and Instruction	Modified

ICR Details

OMB Control No: 2577-0229	ICR Reference No: 201412-2577-001
Status: Historical Active	Previous ICR Reference No: 201201-2577-001
Agency/Subagency: HUD/PIH	Agency Tracking No: PRA-2011-25
Title: Application for the Resident Opportunities and Self Sufficiency (ROSS) Program
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 06/08/2015
	Date Received in OIRA: 03/17/2015
Terms of Clearance: In accordance with 5 CFR 1320, this information collection is approved for 3 years. HUD's collection now displays the OMB Control Number and informs respondents of its legal significance in accordance with 5 CFR 1320.5(b) and satisfies previous terms of clearance.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2018	36 Months From Approved	06/30/2015
Responses	400	0	700
Time Burden (Hours)	2,200	0	2,425
Cost Burden (Dollars)	0	0	0

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Abstract: Application for the ROSS Service Coordinator grant program for Public Housing; Eligible applicants are PHAs, Tribes/TDHEs, Non-Profits and Resident Associations. Information collected will be used to evaluate applications and award grants.

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Authorizing Statute(s): PL: Pub.L. 105 - 276 112 Stat. 2461 Name of Law: Public Housing Reform Act
  

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 78898	12/31/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 12192	03/06/2015
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
Application for the Resident Opportunities and Self Sufficiency (ROSS) Program	HUD-52768 - Revised Version, HUD-52754, HUD-52769 - Revised Version, HUD-52768 - Original Version, HUD-52769 - Original Version, HUD-52752, HUD-52753, HUD-52755	ROSS Service Coordinators - NEEDS and SERVICE PARTNERS ,   Certification of Consistency with the Indian Housing Plan ,   ROSS Funding - Certification of Election of Resident Council Board ,   List of Resident Organizations Supporting Nonprofit Applicants ,   Sample Contract - Administrative Partnership Agreement ,   ROSS Service Coordinators - Funding Request ,   ROSS Service Coordinators - NEEDS and SERVICE PARTNERS ,   ROSS Service Coordinators - Funding Request

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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	400	700	0	0	-300	0
Annual Time Burden (Hours)	2,200	2,425	0	0	-225	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: 14. This collection package is a revision of a previously approved collection. This revision is necessary in order to renew the collection and to submit the revisions to the 52768 (ROSS SERVICE COORDINATORS – FUNDING REQUEST). The revisions were necessary in order to better identify types of Resident Association applicants and their nonprofit or incorporated status. The burden hours have been reduced from a total of 2,425 hours to a total of 2200 because one form, the HUD 52651 (FSS Funding Request Form) was removed from the collection. This form was removed because the FSS program no longer falls under the ROSS program. The burden hours were estimated by HUD staff that completed sample packages of forms.

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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: 03/17/2015

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