Information Collection

Indian Housing Block Grants (IHBG) Program Reporting

IC 27892 under ICR 201512-2577-005 · OMB 2577-0218.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2577-0218 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form HUD-4117 Indian Housing Block Grants (IHBG) Program Reporting	Form and Instruction
HUD-52737 Indian Housing Block Grant (IHBG) IHP/APR HUD 52737 Word.docx	Form and Instruction
HUD-4117 Formula Response Form: Indian Housing BlockGrant Formula HUD-4117.doc	Form and Instruction
HUD-4117 Appendix A1: Conveyance of Formula Current Assisted Stoc HUD-4117 Appendix A1.docx	Form and Instruction
HUD-4119 Challenging National Center for Health Statistics Birth HUD-4119 Appendix B.doc	Form and Instruction
HUD-4119 Appendix C - Challenging Total Development Cost Data: Gu HUD-4119 Appendix C.doc	Form and Instruction
HUD-4119 Appendix D - Challenging Fair Market Rent Data: Guidelin HUD-4119 Appendix D.doc	Form and Instruction
HUD-4119 Appendix E - Challenging Total Resident Service Area Ind HUD-4119 Appendix E.doc	Form and Instruction
HUD-4119 Challenging U.S. Decennial: Census Data: Guidelines for HUD-4119.pdf	Form and Instruction
HUD-52737 EPIC IHP/APR Screen Views HUD-52737 EPIC Screen Views.docx	Form and Instruction
HUD-52737 IHP-APR One Year Plan and Annual Performance Report HUD 52737 IHP-APR.xlsm	Form and Instruction
HUD-52736-A Depository Agreement (Banker) HUD-52736-A Depository Agreement - Banker.doc	Form and Instruction
HUD-52736-B Depository Agreement (Broker) HUD-52736-B - Depository Agreement - Broker.doc	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Indian Housing Block Grants (IHBG) Program Reporting

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 24 CFR 1000

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-4117	Formula Response Form: Indian Housing BlockGrant Formula Data	HUD-4117.doc	Yes	Yes	Fillable Printable
Form and Instruction	HUD-52737	Indian Housing Block Grant (IHBG) IHP/APR	HUD 52737 Word.docx	Yes	Yes	Fillable Printable
Form and Instruction	HUD-4117	Appendix A1: Conveyance of Formula Current Assisted Stock (FCAS) Units	HUD-4117 Appendix A1.docx	Yes	Yes	Fillable Fileable Signable
Form and Instruction	HUD-4119	Challenging National Center for Health Statistics Birth and Death Rate Data: Guidelines for the Indian Housing Block Grant Formula	HUD-4119 Appendix B.doc	Yes	Yes	Fillable Printable
Form and Instruction	HUD-4119	Appendix C - Challenging Total Development Cost Data: Guidelines for the Indian Housing Block Grant Formula	HUD-4119 Appendix C.doc	Yes	Yes	Fillable Fileable
Form and Instruction	HUD-4119	Appendix D - Challenging Fair Market Rent Data: Guidelines for the Indian Housing Block Grant Formula	HUD-4119 Appendix D.doc	Yes	Yes	Fillable Fileable
Form and Instruction	HUD-4119	Appendix E - Challenging Total Resident Service Area Indian Population Data: Guidelines for the Indian Housing Block Grant Formula	HUD-4119 Appendix E.doc	Yes	Yes	Fillable Fileable
Form and Instruction	HUD-4119	Challenging U.S. Decennial: Census Data: Guidelines for the Indian Housing Block Grant Formula	HUD-4119.pdf	Yes	Yes	Fillable Printable
Form and Instruction	HUD-52737	EPIC IHP/APR Screen Views	HUD-52737 EPIC Screen Views.docx	Yes	Yes	Fillable Printable
Form and Instruction	HUD-52737 IHP-APR	One Year Plan and Annual Performance Report	HUD 52737 IHP-APR.xlsm	Yes	Yes	Fillable Printable
Form and Instruction	HUD-52736-A	Depository Agreement (Banker)	HUD-52736-A Depository Agreement - Banker.doc	Yes	Yes	Fillable Fileable Signable
Form and Instruction	HUD-52736-B	Depository Agreement (Broker)	HUD-52736-B - Depository Agreement - Broker.doc	Yes	Yes	Fillable Fileable Signable

Federal Enterprise Architecture Business Reference Module

Line of Business: Community and Social Services

Subfunction: Homeownership Promotion

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 366

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 60 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,779	0	1,779
Annual IC Time Burden (Hours)	47,967	-244	48,211
Annual IC Cost Burden (Dollars)	0	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.