Information Collection

Family Report, MTW 50058 Form

IC 255184 under ICR 202207-2577-001 · OMB 2577-0083.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2577-0083 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form HUD-50058 Family Report, MTW 50058 Form	Form and Instruction
HUD-50058 Family Report MTW 50058 new - emergency PRA.docx	Form and Instruction
HUD-50058 Family Report MTW 50058 new - emergency PRA.docx	Form and Instruction

IC Title:

Family Report, MTW 50058 Form

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	HUD-50058	Family Report MTW	50058 new - emergency PRA.docx		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 4,153

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,933,713	2,933,713
Annual IC Time Burden (Hours)	110,408,733	110,408,733
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.