Family Report, MTW Family Report, MTW Expansion Family Report

Forms and Documents

Document Name	Status
Form HUD 50058 MTW (Une Family report, MTW Family Report, MTW Expansion Family Report Form and Instruction	Modified
83i and Supporting Statement 6-17-20.pdf Supporting Statement A	2020-06-17
Signed-Approved PTA.pdf Supplementary Document	2020-05-13
Published 30-day FR Notice - 2577-0083.pdf Supplementary Document	2020-05-13
Published 60-day FR Notice - 2577-0083_copy.pdf Supplementary Document	2020-05-13

IC Document Collections

IC ID	Document Title	Status
42109	Family report, MTW Family Report, MTW Expansion Family Report Form and Instruction	Modified

ICR Details

OMB Control No: 2577-0083	ICR Reference No: 201908-2577-001
Status: Active	Previous ICR Reference No: 201608-2577-001
Agency/Subagency: HUD/PIH	Agency Tracking No: 2577-0083
Title: Family Report, MTW Family Report, MTW Expansion Family Report
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: 12/04/2020
	Date Received in OIRA: 06/30/2020
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2023	36 Months From Approved	12/31/2020
Responses	2,933,713	0	2,933,713
Time Burden (Hours)	1,104,087	0	1,104,087
Cost Burden (Dollars)	0	0	0

---

Abstract: Tenant data is collected understand demographic, family profile, income, and housing information for participants in the Public Housing, Section 8 Housing Choice Voucher, Section 8 Project Based Certificate, Section 8 Moderate Rehabilitation, and Moving to Work Demonstration programs. This data also allows HUD to monitor the performance of programs and the performance of public housing agencies that administer the programs.

---

Authorizing Statute(s): US Code: 42 USC 1437 et seq Name of Law: United States Housing Act of 1937
  

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:
	84 FR 42943	08/19/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 5225	01/29/2020
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Family report, MTW Family Report, MTW Expansion Family Report	HUD 50058 MTW (Unedited Version), 50058, HUD 50058	Moving to Work Family Report ,   MTW Expansion Family Report ,   Family Report

---

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	2,933,713	2,933,713	0	0	0	0
Annual Time Burden (Hours)	1,104,087	1,104,087	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:

---

Annual Cost to Federal Government: $3,143,000

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? No

---

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: 06/30/2020

---