Veterans Home Rehabilitation Program

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form HUD 27061 Race adn Ethnic Data Reporting Form	Form	Unchanged	Available
Form HUD 27300 Questionmaire for HUD's Initiative on Removal of Regulatory Barriers	Form	Unchanged	Available
Form HUD 2994-A Grant Application Survey	Form and Instruction	Unchanged	Available
Form HUD 2993 Acknowledgment of Application Receipt	Form	Unchanged	Available
Form HUD 2991 Certification of Consistency with the Consolidated Plan	Form	Unchanged	Available
Form HUD 2880 Applicant/Recipent Disclosure /Update Report	Form	Unchanged	Available
Form HUD 424-CB HUD Grant Application Detailed Budget	Form	Unchanged	Available
Form HUD 424 CBWI HUD Grant Application Budget Worksheet	Form	Unchanged	Available
30 Day notice 2018.pdf	Supplementary Document	Uploaded 2018-01-23	Available
Veterans Housing Rehabilitation and Modification Program IPA Form - 12-19-2017.docx	Supplementary Document	Uploaded 2018-01-16	Available
Final - Veterans Housing Rehabilitation and Modification Program - Supporting Statement - 1-29-2018.docx	Supporting Statement A	Uploaded 2018-02-02	Available
Signed IPA.pdf	Supplementary Document	Uploaded 2016-10-18	Available
30 Day notice.pdf	Supplementary Document	Uploaded 2016-10-18	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
223986	Veterans Home Rehabilitation Program	Form	Unchanged	Race adn Ethnic Data Reporting Form
223986	Veterans Home Rehabilitation Program	Form	Unchanged	Questionmaire for HUD's Initiative on Removal of Regulatory Barriers
223986	Veterans Home Rehabilitation Program	Form and Instruction	Unchanged	Grant Application Survey
223986	Veterans Home Rehabilitation Program	Form	Unchanged	Acknowledgment of Application Receipt
223986	Veterans Home Rehabilitation Program	Form	Unchanged	Certification of Consistency with the Consolidated Plan
223986	Veterans Home Rehabilitation Program	Form	Unchanged	Applicant/Recipent Disclosure /Update Report
223986	Veterans Home Rehabilitation Program	Form	Unchanged	HUD Grant Application Detailed Budget
223986	Veterans Home Rehabilitation Program	Form	Unchanged	HUD Grant Application Budget Worksheet

ICR Details

OMB Control No: 2506-0213	ICR Reference No: 201801-2506-002
Status: Historical Active	Previous ICR Reference No: 201607-2506-004
Agency/Subagency: HUD/CPD	Agency Tracking No:
Title: Veterans Home Rehabilitation Program
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/16/2018
Retrieve Notice of Action (NOA)	Date Received in OIRA: 02/02/2018
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2021	36 Months From Approved
Responses	200	0	0
Time Burden (Hours)	2,510	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The purpose of this submission is for applications for the Veterans Home Rehabilitation Program grant process. The Veterans Home Rehabilitation program is funded by the Consolidated Appropriations Act of 2016, Section 1079 (Public Law 113-291). Information is required to rate and rank competitive applications and to ensure eligibility of applicants for funding. Quarterly reporting is required to monitor grant management.

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Authorizing Statute(s): PL: Pub.L. 113 - 291 1079 Name of Law: Consolidated Appropriations Act of 2016
  

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:
	81 FR 39944	06/20/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 3177	01/23/2018
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
Veterans Home Rehabilitation Program	HUD 2991, HUD 424-CB, HUD 424 CBWI, HUD 2993, HUD 2994-A, HUD 2880, HUD 27300, HUD 27061	HUD Grant Application Budget Worksheet ,   HUD Grant Application Detailed Budget ,   Applicant/Recipent Disclosure /Update Report ,   Certification of Consistency with the Consolidated Plan ,   Acknowledgment of Application Receipt ,   Grant Application Survey ,   Questionmaire for HUD's Initiative on Removal of Regulatory Barriers ,   Race adn Ethnic Data Reporting Form

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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	200	0	0	200	0	0
Annual Time Burden (Hours)	2,510	0	0	2,510	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new collection. Thus, no changes are applicable to items 13 and 14.

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Annual Cost to Federal Government: $29,028

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.     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: 02/02/2018

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