Federal Labor Standards Questionnaire(s); Complaint Intake Form

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form HUD-4730 Federal Labor Standards Questionnaire	Form and Instruction	Modified	Available
Form HUD-4731 Federal Labor standards Complaint Intake Form	Form and Instruction	Unchanged	Available
Form HUD-4730- Spanish Federal Labor Standards Questionnaire Spansh Version	Form and Instruction	Modified	Repair queued
30 day FRN.pdf	Supplementary Document	Uploaded 2020-10-26	Available
final - 2501-0018 SS.docx	Supporting Statement A	Uploaded 2020-10-26	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
26959	Federal Labor Standards Questionnaire	Form and Instruction	Modified	Federal Labor Standards Questionnaire
224330	Federal Labor Standards Complaint Intake Form	Form and Instruction	Unchanged	Federal Labor standards Complaint Intake Form
224329	Federal Labor Standards Questionnaire Spanish version	Form and Instruction	Modified	Federal Labor Standards Questionnaire Spansh Version

ICR Details

OMB Control No: 2501-0018	ICR Reference No: 202010-2501-002
Status: Historical Active	Previous ICR Reference No: 201611-2501-002
Agency/Subagency: HUD/HUDSEC	Agency Tracking No:
Title: Federal Labor Standards Questionnaire(s); Complaint Intake Form
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/05/2021
Retrieve Notice of Action (NOA)	Date Received in OIRA: 10/26/2020
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2024	36 Months From Approved
Responses	2,500	0	0
Time Burden (Hours)	1,250	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The information is used by HUD to fulfill its obligation to enforce Federal Labor stanards provisions, especially to act upon allegations of labor standards violations.

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Authorizing Statute(s): None

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:
	85 FR 524	01/06/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 46162	07/31/2020
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
Federal Labor Standards Complaint Intake Form	HUD-4731	Federal Labor standards Complaint Intake Form
Federal Labor Standards Questionnaire	HUD-4730	Federal Labor Standards Questionnaire
Federal Labor Standards Questionnaire Spanish version	HUD-4730- Spanish version	Federal Labor Standards Questionnaire Spansh Version

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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	2,500	0	0	700	0	1,800
Annual Time Burden (Hours)	1,250	0	0	350	0	900
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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Reinstatement

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Annual Cost to Federal Government: $32,782

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? No

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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: 10/26/2020

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