Jobs Plus Pilot Program

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form HUD-50144 Summary Job Plus Budget	Form and Instruction	Modified	Available
Form HUD-242 CBW Grant Application Detailed Budget Worksheet	Form and Instruction	Modified	Available
Form HUD-96011 Facsimile Transmittal	Form and Instruction	Modified	Available
Form HUD-2993 Acknowledgment of Application Receipt	Form and Instruction	Modified	Available
Form HUD-2880 Application/Recipient Disclosure/Update Report	Form and Instruction	Modified	Available
Form SF-LLL Disclosure of Lobbying Activities	Form and Instruction	Modified	Available
Form HUD-424CBW-I Instructions for Completing the Grant Application Detailed Budget Worksheet	Form and Instruction	Modified	Available
Form SF-424 Application for Federal Assistance	Form and Instruction	Modified	Available
Form HUD-424-CB Grant Application Detailed Budget	Form and Instruction	Modified	Available
2577-0281(F).docx	Supporting Statement A	Uploaded 2018-11-29	Available
FR-6004-N-08-60-day FR Notice.docx	Supplementary Document	Uploaded 2017-11-30	Available
Published 60-day FR Notice.pdf	Supplementary Document	Uploaded 2017-11-30	Available
PTA Forms.docx	Supplementary Document	Uploaded 2017-11-30	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
212823	Jobs Plus Pilot Program	Form and Instruction	Modified	Summary Job Plus Budget
212823	Jobs Plus Pilot Program	Form and Instruction	Modified	Grant Application Detailed Budget Worksheet
212823	Jobs Plus Pilot Program	Form and Instruction	Modified	Facsimile Transmittal
212823	Jobs Plus Pilot Program	Form and Instruction	Modified	Acknowledgment of Application Receipt
212823	Jobs Plus Pilot Program	Form and Instruction	Modified	Application/Recipient Disclosure/Update Report
212823	Jobs Plus Pilot Program	Form and Instruction	Modified	Disclosure of Lobbying Activities
212823	Jobs Plus Pilot Program	Form and Instruction	Modified	Instructions for Completing the Grant Application Detailed Budget Worksheet
212823	Jobs Plus Pilot Program	Form and Instruction	Modified	Application for Federal Assistance
212823	Jobs Plus Pilot Program	Form and Instruction	Modified	Grant Application Detailed Budget

ICR Details

OMB Control No: 2577-0281	ICR Reference No: 201706-2577-001
Status: Historical Active	Previous ICR Reference No: 201408-2577-003
Agency/Subagency: HUD/PIH	Agency Tracking No: 2577-0281
Title: Jobs Plus Pilot Program
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 05/14/2019
Retrieve Notice of Action (NOA)	Date Received in OIRA: 11/29/2018
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2022	36 Months From Approved
Responses	75	0	0
Time Burden (Hours)	7,403	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The information is required to allow HUD to conduct a competition to award and obligate Jobs Plus grant funds in accordance with the FY 2014 Appropriations Act, which permits HUD to use up to $15M of the appropriation for Jobs Plus Initiative

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Authorizing Statute(s): US Code: 44 USC Chapter 35 as amended Name of Law: Section 3507 of the Paperwork Reduction Act of 1995
  

Citations for New Statutory Requirements: US Code: 9 USC 1437q Name of Law: U.S. Housing Act of 1937

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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:
	82 FR 47240	10/11/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 1269	01/10/2018
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
Jobs Plus Pilot Program	HUD-424-CB, SF-424, SF-LLL, HUD-96011, HUD-242 CBW, HUD-424CBW-I, HUD-2880, HUD-2993, HUD-50144	Grant Application Detailed Budget ,   Application for Federal Assistance ,   Instructions for Completing the Grant Application Detailed Budget Worksheet ,   Disclosure of Lobbying Activities ,   Application/Recipient Disclosure/Update Report ,   Acknowledgment of Application Receipt ,   Facsimile Transmittal ,   Grant Application Detailed Budget Worksheet ,   Summary Job Plus Budget

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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	75	0	0	0	-50	125
Annual Time Burden (Hours)	7,403	0	0	-69	-1,487	8,959
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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The total number of hours requested decreased by 1,487 hours (8959 – 7472) which reflect a seventeen percent decrease from the previously approved PRA. The original number of annual respondents was estimated to be 125. The last three competitions indicate that 75 annual respondents are more reflective of the estimate number of annual replies to the Jobs Plus NOFA. Based on COLA increases, the annual cost decreased by $1,337 ($315,545 - $314,208).

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Annual Cost to Federal Government: $406,138

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

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: 11/29/2018

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