Information Collection

Jobs Plus Pilot Program

IC 212823 under ICR 201706-2577-001 · OMB 2577-0281.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2577-0281 can be found here:

Documents and Forms

Document Name Document Type
Form HUD-424-CB Jobs Plus Pilot Program Form and Instruction
HUD-424-CB Grant Application Detailed Budget HUD-424-CB.pdf Form and Instruction
SF-424 Application for Federal Assistance SF424.pdf Form and Instruction
HUD-424CBW-I Instructions for Completing the Grant Application Detail HUD-424CBW-I.doc Form and Instruction
SF-LLL Disclosure of Lobbying Activities SF-LLL.pdf Form and Instruction
HUD-2880 Application/Recipient Disclosure/Update Report HUD-2880.pdf Form and Instruction
HUD-2993 Acknowledgment of Application Receipt HUD-2993.pdf Form and Instruction
HUD-96011 Facsimile Transmittal HUD-96011.pdf Form and Instruction
HUD-242 CBW Grant Application Detailed Budget Worksheet HUD 424-cbw.xls Form and Instruction
HUD-50144 Summary Job Plus Budget Form HUD-50144.xls Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Jobs Plus Pilot Program	Agency IC Tracking Number:	2577-NEW

Is this a Common Form? Yes		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	HUD-424-CB	Grant Application Detailed Budget	HUD-424-CB.pdf	Yes	Yes	Fillable Printable
Form and Instruction	SF-424	Application for Federal Assistance	SF424.pdf	Yes	Yes	Fillable Printable
Form and Instruction	HUD-424CBW-I	Instructions for Completing the Grant Application Detailed Budget Worksheet	HUD-424CBW-I.doc	Yes	Yes	Fillable Fileable
Form and Instruction	SF-LLL	Disclosure of Lobbying Activities	SF-LLL.pdf	Yes	Yes	Fillable Fileable Signable
Form and Instruction	HUD-2880	Application/Recipient Disclosure/Update Report	HUD-2880.pdf	Yes	Yes	Fillable Fileable Signable
Form and Instruction	HUD-2993	Acknowledgment of Application Receipt	HUD-2993.pdf	Yes	Yes	Fillable Fileable Signable
Form and Instruction	HUD-96011	Facsimile Transmittal	HUD-96011.pdf	Yes	Yes	Fillable Printable
Form and Instruction	HUD-242 CBW	Grant Application Detailed Budget Worksheet	HUD 424-cbw.xls	Yes	Yes	Fillable Printable
Form and Instruction	HUD-50144	Summary Job Plus Budget	Form HUD-50144.xls	Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 75	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	75	0	-50	125
Annual IC Time Burden (Hours)	7,403	-69	-1,487	8,959
Annual IC Cost Burden (Dollars)	0	0	0	0

Documents for IC

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.