Application for the Resident Opportunities and Self Sufficiency (ROSS) Program

Forms and Documents

Document Name	Status
Form HUD-52768 Application for the Resident Opportunities and Self Sufficiency (ROSS) Program Form and Instruction	Modified
Change Request 83c _ROSS 1.0 .docx Justification for No Material/Nonsubstantive Change	2018-03-22
83i 1-11-2017.doc Supporting Statement A	2017-01-11
IPA Forms.docx Supplementary Document	2016-12-30
Published 60-day FRN.pdf Supplementary Document	2016-12-30

IC Document Collections

IC ID	Document Title	Status
42121	Application for the Resident Opportunities and Self Sufficiency (ROSS) Program Form and Instruction	Modified

ICR Details

OMB Control No: 2577-0229	ICR Reference No: 201803-2577-003
Status: Active	Previous ICR Reference No: 201611-2577-001
Agency/Subagency: HUD/PIH	Agency Tracking No: 2577-0229
Title: Application for the Resident Opportunities and Self Sufficiency (ROSS) Program
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/10/2018
	Date Received in OIRA: 04/03/2018
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2020	08/31/2020	08/31/2020
Responses	350	0	350
Time Burden (Hours)	1,907	0	1,907
Cost Burden (Dollars)	0	0	0

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Abstract: Application for the ROSS Service Coordinator grant program for Public Housing; Eligible applicants are PHAs, Tribes/TDHEs, Non-Profits and Resident Associations. Information collected will be used to evaluate applications and award grants.

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Authorizing Statute(s): PL: Pub.L. 105 - 276 112 Stat. 2461 Name of Law: Public Housing Reform Act
  

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 92843	12/20/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 28087	06/20/2017
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
Application for the Resident Opportunities and Self Sufficiency (ROSS) Program	HUD-52768, HUD-52768	Resident Opportunity & Self-Sufficiency (ROSS) Service Coordinator Funding ,   Resident Opportunity & Self-Sufficiency (ROSS) Service Coordinator Funding

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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	350	350	0	0	0	0
Annual Time Burden (Hours)	1,907	1,907	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: $0

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: 04/03/2018

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