Bureau of Indian Affairs Housing Improvement Program

Forms and Documents

Document Name	Status
Government Performance Results Act Reporting Form Form	New
Tribal Annual Performance Report Form and Instruction	New
Addendum to Application Form	Modified
Form BIA 6407 Housing Improvement Program Application Form and Instruction	Modified
12-21-18.Agency ICActivities; Submission to the OMB for Review and Approval; Bureau of Indian Affairs Housing Improvement Program.pdf Supplementary Document	2018-12-21
2018 1076-0184 HIP Supporting Statement FINAL.docx Supporting Statement A	2018-12-11
8-28-18.Agency IC Activities; Bureau of Indian Affairs Housing Improvement Program 60-day notice.pdf Supplementary Document	2018-12-07
25 USC 13.pdf Supplementary Document	2014-09-10

IC Document Collections

IC ID	Document Title	Status
234446	Government Performance Results Act Reporting Form Form	New
234445	Tribal Annual Performance Report Form and Instruction	New
213185	Addendum to Application Form	Modified
213085	Housing Improvement Program Application Form and Instruction	Modified

ICR Details

OMB Control No: 1076-0184	ICR Reference No: 201812-1076-002
Status: Active	Previous ICR Reference No: 201512-1076-001
Agency/Subagency: DOI/BIA	Agency Tracking No:
Title: Bureau of Indian Affairs Housing Improvement Program
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/12/2019
	Date Received in OIRA: 12/21/2018
Terms of Clearance: In accordance with 5 CFR 1320, the information collection is approved for three years.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2022	36 Months From Approved	02/28/2019
Responses	12,523	0	10,000
Time Burden (Hours)	5,185	0	4,000
Cost Burden (Dollars)	0	0	20,000

---

Abstract: Submission of this information allows BIA to determine applicant eligibility for housing services based upon the criteria referenced in 25 CFR 256.9 (repairs and renovation assistance) and 256.10 (replacement housing assistance). Enrolled members of federally recognized tribes, who live within a tribe’s designated and approved service area, submit information on an application form. The information is collected on a BIA Form 6407, “Housing Assistance Application,” and includes: applicant information; family information including; income information; housing information including; land information; general information; and an applicant certification including. The program also seeks OMB approval for two additional collections. The Tribal Annual Performance Report (TAPR) Excel workbook file, is a tool created to simplify the process for the tribal servicing housing office to verify eligibility, rank, and rate each application received. The Government Performance Results Act (GPRA) Reporting Form is a tool created to simplify the process for the tribal servicing housing office to report the amount of administrative and construction funds spent each quarter of the first fiscal year after receipt of HIP funding.

---

Authorizing Statute(s): US Code: 25 USC 13 Name of Law: Expenditures of Appropriations by Bureau
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 43892	08/28/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 65713	12/21/2018
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 4

IC Title	Form No.	Form Name
Tribal Annual Performance Report	N/A	Tribal Annual Performance Report (TAPR) Excel workbook
Government Performance Results Act Reporting Form	N/A	Government Performance Results Act (GPRA) Reporting Form
Housing Improvement Program Application	BIA 6407	Housing Improvement Program Application
Addendum to Application	N/A	HOUSING IMPROVEMENT PROGRAM ADDENDUM to BIA FORM 6407

---

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	12,523	10,000	0	2,523	0	0
Annual Time Burden (Hours)	5,185	4,000	0	1,185	0	0
Annual Cost Burden (Dollars)	0	20,000	0	-20,000	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The yearly update to the applications, now recorded on the Addendum, was included in the last ICR renewal’s burden estimate for the Application, but we have now broken down the burden estimate for each individual instrument (the Application and the Addendum). The Addendum to the Application was developed in an effort to decrease the burden on the previous years’ applicants by allowing them to fill out a simple one page form for any changes, instead of an entire new application every year. The TAPR was developed to simplify the process for the tribal servicing housing office when submitting Application information to HIP. The GPRA Reporting form was created to simplify the process for the tribal servicing housing office to report the amount of administrative and construction funds spent each quarter of the first fiscal year after receipt of HIP funding. Also, previously a non-hour cost burden of $10 was associated with this collection. The program is no longer accounting for this cost as it was not predicated on information related to the collection. The information that Tribes and individuals are asked to submit will not actually incur any non-hour cost burden. Additionally, when this information collection was renewed in 2015, the government burden was calculated incorrectly. The burden given then was the amount of funding the program received as part of the budget and not the salary and hourly burden associated with the program’s administration of the information.

---

Annual Cost to Federal Government: $20,981

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.     Yes

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

---

Common Form ICR:  No

---

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: 12/21/2018

---