Pay for Success Permanent Supportive Housing Demonstration (PFS) Demonstration

Forms and Documents

Document Name	Status
Form HUD 2993 Pay for Success Permanent Supportive Housing Demonstration Form	Modified
30 day notice.pdf Supplementary Document	2015-10-05
IPA for PFS June 2015.doc Supplementary Document	2015-07-28
Supporting Statement explanation - PFS July 2015.doc Supporting Statement A	2015-07-28

IC Document Collections

IC ID	Document Title	Status
217148	Pay for Success Permanent Supportive Housing Demonstration Form	Modified

ICR Details

OMB Control No: 2506-0207	ICR Reference No: 201507-2506-001
Status: Historical Active	Previous ICR Reference No: 201506-2506-002
Agency/Subagency: HUD/CPD	Agency Tracking No:
Title: Pay for Success Permanent Supportive Housing Demonstration (PFS) Demonstration
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: 12/15/2015
	Date Received in OIRA: 10/06/2015
Terms of Clearance: OMB requests that HUD reassess the burden for the package during the re-submission process by consulting with 9 or fewer respondents who completed the application process and update the burden estimates at that time.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2016	36 Months From Approved	12/31/2015
Responses	9	0	9
Time Burden (Hours)	195	0	195
Cost Burden (Dollars)	0	0	0

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Abstract: The PFS Demonstration NOFA requires private and public nonprofit applicants to respond to selection criteria by demonstrating their experience and expertise in PFS financing and by describing the intended program design. The full application consists of narrative answers and a list of required attachments. A work plan will be development jointly with HUD for each grantee, and will serve as the benchmark for ongoing recordkeeping and reporting

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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:
	80 FR 43107	07/21/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 60166	10/05/2015
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
Pay for Success Permanent Supportive Housing Demonstration	HUD 2993, SF-424 Supplement, HUD 2880, HUD 96011, SFLLL, SF 424 2	Acknowledgment of Application Receipt ,   Third Party Documentation ,   Applicant/Recipient/Disclosure/Update Report ,   DISCLOSURE OF LOBBYING ACTIVITIES ,   SURVEY ON ENSURING EQUAL OPPORTUNITY FOR APPLICANTS ,   Application for Federal Assistance SF-424

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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	9	9	0	0	0	0
Annual Time Burden (Hours)	195	195	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: $1,697

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: 10/06/2015

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