Information Collection

Required Screens for the Physical Assessment Subsystem (PASS) Exigent Health & Safety (EH&S) Reporting Application

IC 27931 under ICR 202010-2577-001 · OMB 2577-0241.

Documents and Forms

Document Name Document Type
Exhibit B -Templates- 081020.docx Other-Template
Exhibit B -Templates- 081020.docx Other-Template

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Required Screens for the Physical Assessment Subsystem (PASS) Exigent Health & Safety (EH&S) Reporting Application	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 24 CFR 902 subpart B 24 CFR part 5 subpart G (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Template			Exhibit B -Templates- 081020.docx		Yes	Yes	Fillable Fileable Signable

Line of Business: Community and Social Services

Subfunction: Homeownership Promotion

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 976	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	976	5	0	971
Annual IC Time Burden (Hours)	329	56	0	273
Annual IC Cost Burden (Dollars)	0	-10,435	10,435	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.