Housing Choice Voucher (HCV) Program and Tribal HUD-VASH

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 52531B PBV - Part AGREEMENT TO ENTER INTO A HOUSING ASSISTANCE PAYMENTS CONTRACT	Form and Instruction	Modified	Available
Form 52531A - PBV Part REDLINED - AGREEMENT TO ENTER INTO A HOUSING ASSISTANCE PAYMENTS CONTRACT	Form and Instruction	Modified	Available
Form 52531A-PBV Part 1 AGREEMENT TO ENTER INTO A HOUSING ASSISTANCE PAYMENTS CONTRACT	Form and Instruction	Modified	Repair queued
Form 52530A PBV New Construction Part 2	Form and Instruction	Modified	Repair queued
Form 52530B PBV Existing Housing Part 2	Form and Instruction	Modified	Available
Form HUD- 5980 Tribal HUD-VASH Leasing Performance Report	Form and Instruction	Modified	Available
Form HUD-52665 Family Portability Information - Housing Choice Voucher Program	Form and Instruction	Modified	Available
Form HUD-52649 Statement of Homeowner Obligations Housing Choice Homeownership Voucher Program	Form and Instruction	Modified	Available
Form HUD-52642 Housing Assistance Payments Contract Manufactured Home Space Rental - Section 8 Tenant-Based Assistance Housing Choice Voucher Program	Form and Instruction	Modified	Available
Form HUD-52580-A Inspection Form - Housing Choice Voucher Program	Form and Instruction	Modified	Available
Form HUD-52580 Inspection Checklist	Form and Instruction	Modified	Available
Form HUD-50164 Unexploded Ordinance Hazards Disclosure-Waikoloa Maneuver Area (WMA)	Form and Instruction	Modified	Available
Form HUD-52667 Utility Allowance Schedule	Form and Instruction	Modified	Available
Form HUD-52641-A Tenancy Addendum	Form and Instruction	Modified	Available
Form HUD-52641 Housing Assistance Payments Contract (HAP Contract) Section 8 Tenant-Based Assistance - Housing Choice Voucher Program	Form and Instruction	Modified	Available
Form HUD-52517 Request for Tenancy Approval - Housing Choice Voucher Program	Form and Instruction	Modified	Available
Form HUD-52515 Funding Application - Housing Choice Voucher Program	Form and Instruction	Modified	Available
Form HUD-XXXX Addendum to the Section 8 Project-Based Voucher Program Housing Assistance Payments Contracr - Existing Housing for PBC Conversions to PBV	Form and Instruction	Modified	Available
Form HUD-52578b Section 8 Project-Based Voucher Program Statement of Family Responsibility	Form and Instruction	Modified	Available
Form HUD-52530.c Tenancy Addendum Section 8 Project-Based Voucher Program	Form and Instruction	Modified	Available
Form HUD-52530B Project-Based Voucher Program Housing Assistance Payments Contract Existing Housing Part 2 of HAP Contract	Form and Instruction	Modified	Available
Form HUD-52530B Project-Based Voucher Program Housing Assistance Payment Contract Existing Housing Part 1 of HAP Contract	Form and Instruction	Modified	Available
Form HUD-52530A Project-Based Voucher Program New Construction or Rehabilitation Part 1 of HAP Contract	Form and Instruction	Modified	Available
Form HUD- 52530A Project-Based Voucher Program New Construction or Rehabilitation Part 2 of HAP Contract	Form and Instruction	Modified	Available
Form HUD- 52530A Housing Choice Voucher (HCV), Program and Tribal HUD-VASH	Form and Instruction	Modified	Repair queued
83c PIH PBV HAP Form Change Request.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2021-11-18	Repair queued
85 FR 61524 (Sep. 29, 2020) - Section 3.pdf	Justification for No Material/Nonsubstantive Change	Uploaded 2021-04-20	Available
83c PIH PBV HAP Form Change Request.docx	Supplementary Document	Uploaded 2021-04-20	Repair queued
FR-7006-N-07 - 60-day FR Notice -HCV and Tribal HUD-VASH.docx	Supplementary Document	Uploaded 2019-02-07	Repair queued
Published 30-day FR Notice.pdf	Supplementary Document	Uploaded 2018-12-18	Repair queued
Published 60-day FR Notice.pdf	Supplementary Document	Uploaded 2018-07-26	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
27839	Housing Choice Voucher (HCV), Program and Tribal HUD-VASH	Form and Instruction	Modified	AGREEMENT TO ENTER INTO A HOUSING ASSISTANCE PAYMENTS CONTRACT
27839	Housing Choice Voucher (HCV), Program and Tribal HUD-VASH	Form and Instruction	Modified	REDLINED - AGREEMENT TO ENTER INTO A HOUSING ASSISTANCE PAYMENTS CONTRACT
27839	Housing Choice Voucher (HCV), Program and Tribal HUD-VASH	Form and Instruction	Modified	AGREEMENT TO ENTER INTO A HOUSING ASSISTANCE PAYMENTS CONTRACT
27839	Housing Choice Voucher (HCV), Program and Tribal HUD-VASH	Form and Instruction	Modified	PBV New Construction Part 2
27839	Housing Choice Voucher (HCV), Program and Tribal HUD-VASH	Form and Instruction	Modified	PBV Existing Housing Part 2
27839	Housing Choice Voucher (HCV), Program and Tribal HUD-VASH	Form and Instruction	Modified	Tribal HUD-VASH Leasing Performance Report
27839	Housing Choice Voucher (HCV), Program and Tribal HUD-VASH	Form and Instruction	Modified	Family Portability Information - Housing Choice Voucher Program
27839	Housing Choice Voucher (HCV), Program and Tribal HUD-VASH	Form and Instruction	Modified	Statement of Homeowner Obligations Housing Choice Homeownership Voucher Program
27839	Housing Choice Voucher (HCV), Program and Tribal HUD-VASH	Form and Instruction	Modified	Housing Assistance Payments Contract Manufactured Home Space Rental - Section 8 Tenant-Based Assistance Housing Choice Voucher Program
27839	Housing Choice Voucher (HCV), Program and Tribal HUD-VASH	Form and Instruction	Modified	Inspection Form - Housing Choice Voucher Program
27839	Housing Choice Voucher (HCV), Program and Tribal HUD-VASH	Form and Instruction	Modified	Inspection Checklist
27839	Housing Choice Voucher (HCV), Program and Tribal HUD-VASH	Form and Instruction	Modified	Unexploded Ordinance Hazards Disclosure-Waikoloa Maneuver Area (WMA)
27839	Housing Choice Voucher (HCV), Program and Tribal HUD-VASH	Form and Instruction	Modified	Utility Allowance Schedule
27839	Housing Choice Voucher (HCV), Program and Tribal HUD-VASH	Form and Instruction	Modified	Tenancy Addendum
27839	Housing Choice Voucher (HCV), Program and Tribal HUD-VASH	Form and Instruction	Modified	Housing Assistance Payments Contract (HAP Contract) Section 8 Tenant-Based Assistance - Housing Choice Voucher Program
27839	Housing Choice Voucher (HCV), Program and Tribal HUD-VASH	Form and Instruction	Modified	Request for Tenancy Approval - Housing Choice Voucher Program
27839	Housing Choice Voucher (HCV), Program and Tribal HUD-VASH	Form and Instruction	Modified	Funding Application - Housing Choice Voucher Program
27839	Housing Choice Voucher (HCV), Program and Tribal HUD-VASH	Form and Instruction	Modified	Addendum to the Section 8 Project-Based Voucher Program Housing Assistance Payments Contracr - Existing Housing for PBC Conversions to PBV
27839	Housing Choice Voucher (HCV), Program and Tribal HUD-VASH	Form and Instruction	Modified	Section 8 Project-Based Voucher Program Statement of Family Responsibility
27839	Housing Choice Voucher (HCV), Program and Tribal HUD-VASH	Form and Instruction	Modified	Tenancy Addendum Section 8 Project-Based Voucher Program
27839	Housing Choice Voucher (HCV), Program and Tribal HUD-VASH	Form and Instruction	Modified	Project-Based Voucher Program Housing Assistance Payments Contract Existing Housing Part 2 of HAP Contract
27839	Housing Choice Voucher (HCV), Program and Tribal HUD-VASH	Form and Instruction	Modified	Project-Based Voucher Program Housing Assistance Payment Contract Existing Housing Part 1 of HAP Contract
27839	Housing Choice Voucher (HCV), Program and Tribal HUD-VASH	Form and Instruction	Modified	Project-Based Voucher Program New Construction or Rehabilitation Part 1 of HAP Contract
27839	Housing Choice Voucher (HCV), Program and Tribal HUD-VASH	Form and Instruction	Modified	Project-Based Voucher Program New Construction or Rehabilitation Part 2 of HAP Contract
27839	Housing Choice Voucher (HCV), Program and Tribal HUD-VASH	Form and Instruction	Modified

ICR Details

OMB Control No: 2577-0169	ICR Reference No: 202111-2577-001
Status: Historical Active	Previous ICR Reference No: 202104-2577-004
Agency/Subagency: HUD/PIH	Agency Tracking No: 2577-0169
Title: Housing Choice Voucher (HCV) Program and Tribal HUD-VASH
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/18/2022
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/31/2022
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2022	07/31/2022	07/31/2022
Responses	3,680,545	0	3,680,545
Time Burden (Hours)	1,643,407	0	1,643,407
Cost Burden (Dollars)	0	0	0

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Abstract: Pursuant to the 1996 MTW Statute and 2016 MTW Expansion Statute (Section 239 of the Fiscal Year 2016 Appropriations Act, P.L. 114-113), Appendix I of the MTW Operations Notice provides waivers of certain provisions of the 1937 Act as well as the implementing requirements and regulations. The MTW HAP Rider is being added to the Housing Assistance Payments Contract for the Section 8-Tenant Based Assistance Housing Choice Voucher Program and the Section 8 Project-Based Voucher Program to ensure that any particular provisions of the HAP Contract differ from or conflict with the MTW activities included in the PHA’s approved MTW Supplement to its PHA Plan, that the provisions of the MTW Operations Notice and the approved MTW Supplement to the PHA Plan will supersede any conflicting or differing HAP Contract language. The MTW HAP Rider will have no significant impact on information collection burden.

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Authorizing Statute(s): US Code: 44 USC Chapter 35, as amended Name of Law: Section 3506 of the Paperwork Reduction Act of 1995
  

Citations for New Statutory Requirements: US Code: 42 USC 3543 Name of Law: Title VI of the Civil Rights Acts of 1964

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
2577-AC86	Final or interim final rulemaking	80 FR 50564	08/20/2015

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 24333	05/25/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 42135	08/20/2018
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Housing Choice Voucher (HCV), Program and Tribal HUD-VASH	HUD- 5980, HUD-52530A, HUD-52530B, HUD-52530B, HUD-XXXX, HUD- 52530A, HUD-52530.c, HUD-52578b, HUD-52667, HUD-52515, HUD-52580-A, HUD-52642 , HUD-50164, HUD-52580, HUD-52641, HUD-52517, HUD-52641-A, HUD-52649, HUD-52665, 52531A-PBV Part 1, 52530B, 52530A, 52531A - PBV Part I - REDLINED, 52531B PBV - Part II	Project-Based Voucher Program New Construction or Rehabilitation Part 2 of HAP Contract ,   Project-Based Voucher Program New Construction or Rehabilitation Part 1 of HAP Contract ,   Project-Based Voucher Program Housing Assistance Payment Contract Existing Housing Part 1 of HAP Contract ,   Project-Based Voucher Program Housing Assistance Payments Contract Existing Housing Part 2 of HAP Contract ,   Tenancy Addendum Section 8 Project-Based Voucher Program ,   Section 8 Project-Based Voucher Program Statement of Family Responsibility ,   Addendum to the Section 8 Project-Based Voucher Program Housing Assistance Payments Contracr - Existing Housing for PBC Conversions to PBV ,   Funding Application - Housing Choice Voucher Program ,   Request for Tenancy Approval - Housing Choice Voucher Program ,   Housing Assistance Payments Contract (HAP Contract) Section 8 Tenant-Based Assistance - Housing Choice Voucher Program ,   Tenancy Addendum ,   Utility Allowance Schedule ,   Unexploded Ordinance Hazards Disclosure-Waikoloa Maneuver Area (WMA) ,   Inspection Checklist ,   Inspection Form - Housing Choice Voucher Program ,   Housing Assistance Payments Contract Manufactured Home Space Rental - Section 8 Tenant-Based Assistance Housing Choice Voucher Program ,   Statement of Homeowner Obligations Housing Choice Homeownership Voucher Program ,   Family Portability Information - Housing Choice Voucher Program ,   Tribal HUD-VASH Leasing Performance Report ,   PBV Existing Housing Part 2 ,   PBV New Construction Part 2 ,   AGREEMENT TO ENTER INTO A HOUSING ASSISTANCE PAYMENTS CONTRACT ,   REDLINED - AGREEMENT TO ENTER INTO A HOUSING ASSISTANCE PAYMENTS CONTRACT ,   AGREEMENT TO ENTER INTO A HOUSING ASSISTANCE PAYMENTS CONTRACT

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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	3,680,545	3,680,545	0	0	0	0
Annual Time Burden (Hours)	1,643,407	1,643,407	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $32,600

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: 01/31/2022

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