final 9-30-21 - Supporting Statement

Supporting Statement for Paperwork Reduction Act Submissions

Application for displacement/relocation/temporary relocation assistance for persons displaced by, or temporarily relocated for, certain HUD programs

OMB # 2506-0016

1. Justification

1. Explain the circumstances that make the collection of information necessary. Identify any legal or administrative requirements that necessitate the collection. Attach a copy of the appropriate section of each statute and regulation mandating or authorizing the collection of information.

Persons displaced or temporarily or permanently relocated for certain HUD programs may have basic eligibility for a relocation payment and must document their claims by filling out a form and submitting it to the housing agency to be paid. The completed claim forms are reviewed by the HUD program participant prior to making payments. Completed forms, evidencing that the claim has been paid to the displaced or temporarily relocated person, are kept in program participant files. Periodically, HUD monitors projects and reviews a random sample of the program participant files to assure that persons received the relocation payments to which they are entitled.

These claim forms can be used by displaced persons (families, individuals, businesses, nonprofit organizations and farms) to apply for relocation assistance payments. Authority for making a relocation payment to persons permanently displaced is found in section 213(b)(2) of the Uniform Relocation Assistance and Real Property Acquisition Policies Act (URA), which states that “a displaced person who makes proper application for a payment authorized for such person by this title shall be paid promptly.” Authority for making a relocation payment under section 104(d) of the Housing and Community Development Act of 1974 (HCD Act), as amended, to low/moderate-income persons who occupied housing demolished or low/moderate-income housing converted to a use other than low or moderate-income housing is found at section 104(d)(2)(A)(iii) and (iv). Authority for making a relocation payment under the National Affordable Housing Act (NAHA) to low/moderate-income persons who occupied housing demolished or low/moderate-income housing converted to a use other than low or moderate-income housing is found at section 212. According to the URA regulations at 49 CFR 24.1 and 24.2(a)(9)(ii)(D), Appendix A, persons who are temporarily relocated are eligible for a relocation payment.

The government-wide rule at 49 CFR 24.207 states “a displaced person must be provided reasonable assistance necessary to complete and file any required claim for payment.” All displaced persons under the government-wide rule must file a claim for a relocation payment within 18 months following their displacement. Persons who are temporarily relocated are not considered “displaced persons,” and the government-wide rule at 49 CFR 24.2(a)(9)(ii)(D) states that “great care must be exercised to ensure that they are treated fairly and equitably. For example, if the tenant-occupant of a dwelling will not be displaced but is required to relocate temporarily in connection with the project, the temporarily occupied housing must be decent, safe, and sanitary and the tenant must be reimbursed for all reasonable out-of-pocket expenses incurred in connection with the temporary relocation. These expenses may include moving expenses and increased housing costs during the temporary relocation.”

To help local program participating agencies meet their URA obligations, the Department has prepared and issued the following optional claim forms to be used as examples in creating their own forms or in using the following HUD example forms:

HUD-40030, English, Claim for Temporary Relocation Expenses (Residential Moves)

HUD-40030, Spanish, Claim for Temporary Relocation Expenses (Residential Moves)

HUD-40030, Vietnamese, Claim for Temporary Relocation Expenses (Residential Moves)

HUD-40030, Arabic, Claim for Temporary Relocation Expenses (Residential Moves)

HUD-40030, Russian, Claim for Temporary Relocation Expenses (Residential Moves)

HUD-40030, Mandarin, Claim for Temporary Relocation Expenses (Residential Moves)

HUD-40030, Korean, Claim for Temporary Relocation Expenses (Residential Moves)

HUD-40054, English, Claim for Temporary Relocation Expenses (Residential Moves)

HUD 40054-Spanish Claim for Moving and Related Expenses – Families and individuals.

HUD 40054-Vietnamese, Claim for Temporary Relocation Expenses (Residential Moves)

HUD 40054-Arabic, Claim for Temporary Relocation Expenses (Residential Moves)

HUD 40054-Russian, Claim for Temporary Relocation Expenses (Residential Moves)

HUD 40054, Mandarin, Claim for Temporary Relocation Expenses (Residential Moves)

HUD 40054-Korean, Claim for Temporary Relocation Expenses (Residential Moves)

HUD-40055, English, Claim for Actual Reasonable Moving and Related Expenses -- Expenses to reestablish a displaced farm, nonprofit organization, or small business at a new site.

HUD-40055, Spanish, Claim for Actual Reasonable Moving and Related Expenses -- Expenses to reestablish a displaced farm, nonprofit organization, or small business at a new site.

HUD-40055, Vietnamese, Claim for Actual Reasonable Moving and Related Expenses -- Expenses to reestablish a displaced farm, nonprofit organization, or small business at a new site.

HUD-40055, Arabic, Claim for Actual Reasonable Moving and Related Expenses -- Expenses to reestablish a displaced farm, nonprofit organization, or small business at a new site.

HUD-40055, Russian, Claim for Actual Reasonable Moving and Related Expenses -- Expenses to reestablish a displaced farm, nonprofit organization, or small business at a new site.

HUD-40055, Mandarin, Claim for Actual Reasonable Moving and Related Expenses -- Expenses to reestablish a displaced farm, nonprofit organization, or small business at a new site.

HUD-40055, Korean, Claim for Actual Reasonable Moving and Related Expenses -- Expenses to reestablish a displaced farm, nonprofit organization, or small business at a new site.

HUD-40056, English, Claim for Fixed Payment in Lieu of Payment for Actual Moving and Related Expenses -- Businesses, Nonprofit Organizations and Farm Operations.

HUD-40056, Spanish, Claim for Fixed Payment in Lieu of Payment for Actual Moving and Related Expenses -- Businesses, Nonprofit Organizations and Farm Operations.

HUD-40056, Vietnamese, Claim for Fixed Payment in Lieu of Payment for Actual Moving and Related Expenses -- Businesses, Nonprofit Organizations and Farm Operations.

HUD-40056, Arabic, Claim for Fixed Payment in Lieu of Payment for Actual Moving and Related Expenses -- Businesses, Nonprofit Organizations and Farm Operations.

HUD-40056, Russian, Claim for Fixed Payment in Lieu of Payment for Actual Moving and Related Expenses -- Businesses, Nonprofit Organizations and Farm Operations.

HUD-40056, Mandarin, Claim for Fixed Payment in Lieu of Payment for Actual Moving and Related Expenses -- Businesses, Nonprofit Organizations and Farm Operations.

HUD-40056, Korean, Claim for Fixed Payment in Lieu of Payment for Actual Moving and Related Expenses -- Businesses, Nonprofit Organizations and Farm Operations.

HUD-40057, English, Claim for Replacement Housing Payment for 180-Day Homeowner. Claim by current homeowners for replacement housing payment.

HUD-40057, Spanish, Claim for Replacement Housing Payment for 180-Day Homeowner. Claim by current homeowners for replacement housing payment

HUD-40057, Vietnamese, Claim for Replacement Housing Payment for 180-Day Homeowner. Claim by current homeowners for replacement housing payment

HUD-40057, Arabic, Claim for Replacement Housing Payment for 180-Day Homeowner. Claim by current homeowners for replacement housing payment

HUD-40057, Russian, Claim for Replacement Housing Payment for 180-Day Homeowner. Claim by current homeowners for replacement housing payment

HUD-40057, Mandarin, Claim for Replacement Housing Payment for 180-Day Homeowner. Claim by current homeowners for replacement housing payment

HUD-40057, Korean, Claim for Replacement Housing Payment for 180-Day Homeowner. Claim by current homeowners for replacement housing payment

HUD-40058, English, Claim for Rental Assistance or Down Payment Assistance. Families and individuals applying for URA assistance.

HUD-40058, Spanish, Claim for Rental Assistance or Down Payment Assistance. Families and individuals applying for URA assistance

HUD-40058, Vietnamese, Claim for Rental Assistance or Down Payment Assistance. Families and individuals applying for URA assistance

HUD-40058, Arabic, Claim for Rental Assistance or Down Payment Assistance. Families and individuals applying for URA assistance

HUD-40058, Russian, Claim for Rental Assistance or Down Payment Assistance. Families and individuals applying for URA assistance

HUD-0058, Mandarin, Claim for Rental Assistance or Down Payment Assistance. Families and individuals applying for URA assistance

HUD-40058, Korean, Claim for Rental Assistance or Down Payment Assistance. Families and individuals applying for URA assistance

HUD-40061, English, Selection of Most Representative Comparable Replacement Dwelling. Program participants establish a ceiling for the purchase price or rental cost of replacement housing.

HUD-40061, Spanish, Selection of Most Representative Comparable Replacement Dwelling. Program participants establish a ceiling for the purchase price or rental cost of replacement housing.

HUD-40061, Vietnamese, Selection of Most Representative Comparable Replacement Dwelling. Program participants establish a ceiling for the purchase price or rental cost of replacement housing.

HUD-40061, Arabic, Selection of Most Representative Comparable Replacement Dwelling. Program participants establish a ceiling for the purchase price or rental cost of replacement housing.

HUD-40061, Russian, Selection of Most Representative Comparable Replacement Dwelling. Program participants establish a ceiling for the purchase price or rental cost of replacement housing.

HUD-40061, Mandarin, Selection of Most Representative Comparable Replacement Dwelling. Program participants establish a ceiling for the purchase price or rental cost of replacement housing.

HUD-40061, Korean, Selection of Most Representative Comparable Replacement Dwelling. Program participants establish a ceiling for the purchase price or rental cost of replacement housing.

HUD-40072, English, Claim for Rental or Purchase Assistance. Families and individuals applying for assistance under section 104(d) of the HCD Act and NAHA (rather than assistance under the URA).

HUD-40072, Spanish, Claim for Rental or Purchase Assistance. Families and individuals applying for assistance under section 104(d) of the HCD Act and NAHA (rather than assistance under the URA)

HUD-40072, Vietnamese, Claim for Rental or Purchase Assistance. Families and individuals applying for assistance under section 104(d) of the HCD Act and NAHA (rather than assistance under the URA)

HUD-40072, Arabic, Claim for Rental or Purchase Assistance. Families and individuals applying for assistance under section 104(d) of the HCD Act and NAHA (rather than assistance under the URA)

HUD-40072, Russian, Claim for Rental or Purchase Assistance. Families and individuals applying for assistance under section 104(d) of the HCD Act and NAHA (rather than assistance under the URA)

HUD-40072, Mandarin, Claim for Rental or Purchase Assistance. Families and individuals applying for assistance under section 104(d) of the HCD Act and NAHA (rather than assistance under the URA)

HUD-40072, Korean, Claim for Rental or Purchase Assistance. Families and individuals applying for assistance under section 104(d) of the HCD Act and NAHA (rather than assistance under the URA)

Pursuant to 5 CFR 1320.4(b), the Department has ensured that collection of information associated with these statutory and regulatory requirements is the least burdensome necessary.

2. Indicate how, by whom and for what purpose the information is to be used. Except for a new collection, indicate the actual use the agency has made of the information received from the current collection.

These forms are not submitted to HUD to collect information. None of the information on any of the forms has changed since the last submission. These forms are basically available so that agencies can use them as guide forms to provide relocation assistance payments to persons displaced from HUD funded projects. The agency can complete the forms for the persons or help persons complete the forms to receive payments. Persons can be either temporarily or permanently displaced from residences or businesses and the displacing agency (program participant) must reimburse them for the costs of moving. For example, HUD-40030 can be used by a person to be reimbursed for temporary relocation costs of additional rent, utilities, and moving costs they may have experienced when the person had to move from their residence on the project and back to their residence at the same project. The information requested is the minimum to meet statutory requirements.

3. Describe whether, and to what extent, the collection of information involves the use of automated, electronic, mechanical, or other technological collection techniques or other forms of information technology, e.g., permitting electronic submission of responses, and the basis for the decision for adopting this means of collection. Also describe any consideration of using information technology to reduce burden.

The forms are not submitted to HUD to collect information. The data on the forms is only used by the displacing agency to calculate and document payments to persons that move from a project area. The program participant’s files should have hard copies of forms and receipts if available to support their determinations for their own audit purposes, or in the event of an appeal for additional payments. Having hard copies in the program participant files is helpful if HUD conducts a monitoring of the program participant’s program to verify that payments were made appropriately. The information stays in the program participant’s files and is not available for other purposes.

4. Describe efforts to identify duplication. Show specifically why any similar information already available cannot be used or modified for use for the purposes described in Item 2 above.

There is no other information collected by a locality under other programs that would serve the same use described in 2. Above.

5. If the collection of information impacts small businesses or other small entities (Item 5 of OMB Form 83-I) describe any methods used to minimize burden.

Small businesses may be displaced by a federally funded project; however, the program participant must provide reimbursement for moving costs. The forms HUD-40055 and HUD 40056 can be used for businesses to complete and submit for payment of moving costs reimbursements. The act of filling out the forms will not cause an economic impact on the businesses. The information requested is the minimum to meet statutory requirements. Local program participating entities are required under the URA to assist displaced persons prepare their claims for payments.

6. Describe the consequence to Federal program or policy activities if the collection is not conducted or is conducted less frequently, as well as any technical or legal obstacles to reducing burden.

Information is not collected on a routine basis and therefore there is not technical or a legal obstacle to reduce a burden. If housing agencies do not make forms such as these examples available to persons displaced from projects, then documenting claims or making payments would be difficult to document. The forms provided in this PRA can be used but are not required by housing agencies to provide to persons displaced. The forms can also be used as examples for the housing agency to create their own forms. A relocation payment claim form is usually kept in a file with the program participant after a person moves. These claim forms can be used by displaced persons (families, individuals, businesses, nonprofit organizations and farms) and persons temporarily relocated to apply for relocation assistance. Authority for making a relocation payment to a displaced person is found in section 213(b)(2) of the URA, which states that “…a displaced person who makes proper application for a payment authorized for such person by this title shall be paid promptly.” Authority for making a relocation payment to a person who is temporarily relocated is found at 49 CFR 24.1 and 49 CFR 24.2(a)(9)(ii)(D), Appendix A. Occasionally, HUD may review participant files for audit purposes to ensure that the persons displaced were provided with the necessary relocation assistance. While these forms are optional, the basic information requested is the minimum amount necessary to determine the accuracy of any claim.

7. Explain any special circumstances that would cause an information collection to be conducted in a manner:

• requiring respondents to report information to the agency more than quarterly;

This is not applicable. HUD does not collect this type of information.

• requiring respondents to prepare a written response to a collection of information in fewer than 30 days after receipt of it;

This is not applicable. HUD does not collect this type of information.

• requiring respondents to submit more than an original and two copies of any document;

This is not applicable. HUD does not collect this type of information.

• requiring respondents to retain records other than health, medical, government contract, grant-in-aid, or tax records for more than three years;

This is not applicable. HUD does not collect this type of information.

• in connection with a statistical survey, that is not designed to produce valid and reliable results than can be generalized to the universe of study;

This is not applicable. HUD does not collect this type of information.

• requiring the use of a statistical data classification that has not been reviewed and approved by OMB;

This is not applicable. HUD does not collect this type of information.

• that includes a pledge of confidentiality that is not supported by authority established in statute or regulation, that is not supported by disclosure and data security policies that are consistent with the pledge, or which unnecessarily impedes sharing of data with other agencies for compatible confidential use; or

This is not applicable. HUD does not collect this type of information.

• requiring respondents to submit proprietary trade secret, or other confidential information unless the agency can demonstrate that it has instituted procedures to protect the information's confidentiality to the extent permitted by law.

This is not applicable. HUD does not collect this type of information.

8. If applicable, provide a copy and identify the date and page number of publication in the Federal Register of the agency's notice, required by 5 CFR 1320.8(d), soliciting comments on the information collection prior to submission to OMB. Summarize public comments received in response to that notice and describe actions taken by the agency in response to these comments. Specifically address comments received on cost and hour burden. Describe efforts to consult with persons outside the agency to obtain their views on the availability of data, frequency of collection, the clarity of instructions and recordkeeping disclosure, or reporting format (if any) and the data elements to be recorded, disclosed, or reported. Consultation with representatives of those from whom information is to be obtained or those who must compile records should occur at least once every 3 years -- even if the collection of information activity is the same as in prior periods. There may be circumstances that preclude consultation in a specific situation. These circumstances should be explained.

The notice of proposed information collection has been published in the Federal Register on July 21, 2021, Volume 86, No.137, page 38495. No comments

Not Applicable.

9. Explain any decision to provide any payment or gift to respondents, other than re-enumeration of contractors or grantees.

No payment or gifts are provided to respondents.

10. Describe any assurance of confidentiality provided to respondents and the basis for assurance in statute, regulation or agency policy.

• Social security numbers are not collected for purposes of these forms. The forms do not contain fields to enter SS numbers. Completed forms are not shared with the public but maintained in the program participant’s files and not by HUD. Only authorized staff from the program participant and HUD and the displaced person have access to the files, unless applicable law provides otherwise. The Privacy act of 1974 provides privacy protection to respondents.  There is no promise of confidentiality.

11. Provide additional justification for any questions of a sensitive nature, such as sexual behavior and attitudes, religious beliefs, and other matters that are commonly considered private. This justification should include the reasons why the agency considers the questions necessary, the specific uses to be made of the information, the explanation to be given to persons from whom the information is requested, and any steps to be taken to obtain their consent.

The only sensitive information asked for on these claim forms are: (a) data on old and new mortgage costs on Claim Form HUD-40057, (b) income and monthly housing costs on Claim Form HUD-40072, (c) the average annual net earnings of a nonresidential claimant on Claim Form HUD-40056 and (d) a certification of eligibility for relocation benefits based on being a citizen or national of the United States or an alien lawfully present in the US. This information is necessary to compute the amount of financial assistance to be provided to the individual, household, or business to offset any increased relocation or housing costs caused by the displacement.

12. Provide estimates of the hour burden of the collection of information. The statement should:

• indicate the number of respondents, frequency of response, annual hour burden, and an explanation of how the burden was estimated. Unless directed to do so, agencies should not conduct special surveys to obtain information on which to base hour burden estimates. Consultation with a sample (fewer than 10) of potential respondents is desirable. If the hour burden on respondents is expected to vary widely because of differences in activity, size, or complexity, show the range of estimated hour burden, and explain the reasons for the variance. Generally, estimates should not include burden hours for customary and usual business practices;

• if this request covers more than one form, provide separate hour burden estimates for each form and aggregate the hour burdens in Item 13 of OMB Form 83-i and

• provide estimates of annualized cost to respondents for the hour burdens for collections of information, identifying and using appropriate wage rate categories. The cost of contracting out or paying outside parties for information collection activities should not be included here. Instead this cost should be included in Item 13.

Assuming all permanently displaced persons file a claim for moving expenses (12,800), all permanently displaced residential occupants file a claim for housing assistance (12,000), all temporarily relocated residential occupants file a claim for temporary relocation expenses (25,000) and each claim for housing assistance requires that a locality select the most representative replacement dwelling (12,000), a total of 56,000 hours would be spent on this activity.

Information Collection	Number of Respondents	Frequency of Response	Responses Per Annum	Burden Hour Per Response	Annual Burden Hours	Hourly Cost Per Response	Annual Cost
HUD 40054	12,000.00	1.00	12,000.00	0.5	6,000.00	$26.09	$156,540.00
HUD 40055	400.00	1.00	400.00	1.5	600.00	$26.09	$15,654.00
HUD 40056	400.00	1.00	400.00	1.0	400.00	$26.09	$10,436.00
HUD 40030	25,000.00	1.00	25,000.00	1.0	25,000.00	$26.09	$652,250.00
HUD 40057	1,250.00	1.00	1,250.00	1.0	1,250.00	$26.09	$32,612.50
HUD 40058	8,750.00	1.00	8,750.00	1.0	8,750.00	$26.09	$228,287.50
HUD 40072	2,000.00	1.00	2,000.00	1.0	2,000.00	$26.09	$52,180.00
HUD 40061	12,000.00	1.00	12,000.00	1.0	12,000.00	$26.09	$313,080.00
Total	61,800.00	1.00	61,800.00	--	56,000.00	$26.09	$1,461,040.00

The estimated cost to localities: 56,000 burden hours (see item 12 above) x $26.09* per hour = $1,461,040.00. Records must be retained for three years after each claimant receives final payment entitled. *$26.09 per hour (based on OPM Washington DC 2021 pay scale for GS 8 step 1.

13. Provide an estimate of the total annual cost burden to respondents or recordkeepers resulting from the collection of information (do not include the cost of any hour burden shown in Items 12 and 14).

• The cost estimate should be split into two components: (a) a total capital and start-up cost component (annualized over its expected useful life); and (b) a total operation and maintenance purchase of services component. The estimates should take into account costs associated with generating, maintaining, and disclosing or providing the information. Include descriptions of methods used to estimate major cost factors including system and technology acquisition, expected useful life of capital equipment, the discount rate(s) and the time period over which costs will be incurred. Capital and start-up costs include, among other items, preparations for collecting information such as purchasing computers and software; monitoring, sampling, drilling and testing equipment; and record storage facilities;

• If cost estimates are expected to vary widely, agencies should present ranges of cost burdens and explain the reasons for the variance. The cost of purchasing or contracting out information collection services should be a part of this cost burden estimate. In developing cost burden estimates, agencies may consult with a sample of respondents (fewer than 10) utilize the 60-day pre-OMB submission public comment process and use existing economic or regulatory impact analysis associated with the rulemaking containing the information collection, as appropriate.

• generally, estimates should not include purchases of equipment or services, or portions thereof made: (1) prior to October 1, 1995, (2) to achieve regulatory compliance with requirements not associated with the information collection, (3) for reasons other than to provide information or keep records for the government, or (4) as part of customary and usual business or private practices.

There are no additional costs to respondents other than the information reported

in item 12.

14. Provide estimates of annualized cost to the Federal government. Also, provide a description of the method used to estimate cost, which should include quantification of hours, operational expenses (such as equipment, overhead, printing, and support staff), and any other expense that would not have been incurred without this collection of information. Agencies also may aggregate cost estimates from Items 12, 13, and 14 in a single table.

Information Collection	Number of Respondents	Frequency of Response	Responses Per Annum	Burden Hour Per Response	Annual Burden Hours	Hourly Cost Per Response	Annual Cost
Total	61,800.00	1.00	61,800.00	--	56,000.00	$26.09	$1,461,040.00

The cost to the Federal Government is minimal since the forms are optional. Cost includes Headquarters periodic review of the forms to update in compliance with law or regulation changes, posting of the forms on the HUD website, submission of OMB paperwork clearance packages, and periodic review by field office staff of a sample of the forms or other records maintained by local program participants with regard to relocation claims made, and responding to inquiries from local program participants or the public with regard to information contained on the forms. Annualized estimate is 2,000 hrs. per year at $26.09 per hour (based on 2021 Washington DC OPM pay scale for GS 8 step 1) $54,440.

15. Explain the reasons for any program changes or adjustments reported in Items 13 and 14 of the OMB Form 83-i.

This is a reinstatement without change the reported annual burden has not changed. However, do state that a minor change was the Cost per response to reflect the GS-2021 pay scale.

16. For collection of information whose results will be published, outline plans for tabulation and publication. Address any complex analytical techniques that will be used. Provide the time schedule for the entire project, including beginning and ending dates of the collection of information, completion of report, publication dates, and other actions.

This information will not be published.

17. If seeking approval to not display the expiration date for OMB approval of the information collection, explain the reasons that display would be inappropriate.

Not seeking such approval.

18. Explain each exception to the certification statement identified in item 19.

There are no exceptions to the certification statement identified in item 19 of

the OMB 83-i.

2. Collections of Information Employing Statistical Methods

The information collection does not employ statistical methods.