HUD-50080-OFND Operating Fund Payment Voucher

U.S. Department of Housing
and Urban Development
Office of Public and Indian Housing

LOCCS /eLOCCS
Operating Fund
Payment Voucher

OMB Approval No. 2577-0166 (exp. 01/31/2021)

Public reporting burden for this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions,
searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. This agency
may not collect this information, and you are not required to complete this form, unless it displays a currently valid OMB control number.
The Line of Credit Control System (LOCCS) is HUD's primary grant and subsidy disbursement system for the majority of HUD programs. Organizations
and individuals have access to these grants through an Internet version of LOCCS called eLOCCS, where authorized Business Partners can access,
manage, and drawdown grant funds. LOCCS is accessed through the Internet Portal, Secure Systems. The information requested does not lend itself to
confidentiality.
1. Voucher Number

2. LOCCS Pgrm. Area

099

3. Period Covered by this Request (mm/yyyy)

OFND

from:

4.

1 = Partial Disbursement
2 = Final Disbursement

to:

5. Voice Response No. (5 digits, hyphen, 5 more )

6. Grantee Organization's Name

7. Payee Organization's Name :

8. Grant or Project No.

6a. Grantee Organization's TIN

7a. Payee Organization's TIN:

9. Line Item No.

1000

Type of Funds Requested

Amount

Operating Subsidy

(dollars)

*

(cents)

*
*
*
*
*
*
*
*
*
*
*
*
*
10.

Voucher Total

$

*

I certify the data reported and funds requested on this voucher are correct.
11. Name & Phone Number (including area code)
of the Person who Completed this form

12. Name & Title of Authorized Signatory (type or print clearly)

13. Signature

14. Date of Request

X
Warning: I/We, the undersigned, certify under penalty of perjury that the information provided above is true and correct. WARNING: Anyone who knowingly submits a false claim
or makes a false statement is subject to criminal and/or civil penalties, including confinement for up to 5 years, fines, and civil and administrative penalties.
(18 U.S.C. §§ 287, 1001, 1010, 1012; 31 U.S.C. §3729, 3802)
Privacy Statement: This state is provided pursuant to the Privacy Act of 1974, 5 USC§ 552a. The authority for collecting personally identifiable information (PII) in the Regulatory
Consistency Communication Board (RCCB) Electronic Feedback Form is based in Section 313 of Public Law 112­95.. The purpose of the data is to safeguard the Line of Credit
Control System (LOCCS) from unauthorized access. The data are used to ensure that individuals who no longer require access to LOCCS have their access capability promptly
deleted. Failure to provide the information requested on the form may delay the processing of your approval for access to LOCCS.

form HUD-50080-OFND (08/2014)