HUD-52306 Request for Technical Review (TR) or Database Adjustment

EXHIBIT E OMB No.2577-0257; Expires / /

Office of Public Housing Real Estate Assessment Center
Request for Technical Review (TR) or Database Adjustment (DBA) of Physical Inspection Report

­­Public Reporting Burden for this information collection is estimated to average 8 hours per respondent, including time for reviewing the inspection, searching existing data sources, gathering and maintaining data needed, and completing and reviewing the collection. Public Housing Agencies (PHAs) and multifamily insured and assisted properties owners/agents (MF POs) may request a database adjustment (DBA) and a technical review (TR) of a project’s physical inspection. This information is being collected to fulfill regulatory requirements that allow PHAs and MF Pos to submit a TR or DBA for the purpose of reviewing a physical inspection report and ensure accurate assessments and scores. Responses are required for HUD to grant a DBA and TR request pursuant to 24 CFR §§ 902.24, 902.68 and 200.857. No assurances of confidentiality are provided for this information collection.

Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions to reduce this burden, to Colette Pollard, Reports Management Officer, QDAM, Department of Housing and Urban Development, 451 7th Street, SW, Room 4176, Washington, DC 20410-5000. When providing comments, please refer to OMB Control No. 2577-0257. HUD may not conduct and sponsor, and a person is not required to respond to a collection of information unless the collection displays a valid OMB Control Number.

Inspection Number_________________________

Inspection Date____________________________

Project/Property Name ______________________

Date of Request ___________________________

TR or DBA ________________________________

Project ID Number ___________________________

Address of Property___________________________

City, State, Zip_______________________________

Contact Name________________________________

Issue #

Location (Inspectable Area) Building Number Unit Number Documentation Type (photo, text, video)

Item and Deficiency /Observation

Reason for Request

Additional Comments

Issue #

Location (Inspectable Area) Building Number Unit Number Documentation Type (photo, text, video)

Item and Deficiency /Observation

Reason for Request

Additional Comments

Issue #

Location (Inspectable Area) Building Number Unit Number Documentation Type (photo, text, video)

Item and Deficiency /Observation

Reason for Request

Additional Comments

Form-HUD 52306