Information Collection

At Risk Receivership/Substandard/Troubled Program

IC 252313 under ICR 202403-2577-005 · OMB 2577-0301.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2577-0301 can be found here:

Documents and Forms

Document Name Document Type
Form HUD-50075.1 At Risk Receivership/Substandard/Troubled Program Form and Instruction
Form HUD-50075.1 At Risk Receivership/Substandard/Troubled Program Form and Instruction
HUD-50075.1 Annual Statement/Performance and Evaluation Report 50075.1.pdf Form and Instruction
HUD-50075.1 Annual Statement/Performance and Evaluation Report 50075.1.pdf Form and Instruction
424-b Instructions for the HUD 424-B Assurances and Certificat 424-B.pdf www.hud.gov/sites/dfiles/OCHCO/documents/424-B.pdf Form and Instruction
424-b Instructions for the HUD 424-B Assurances and Certificat 424-B.pdf www.hud.gov/sites/dfiles/OCHCO/documents/424-B.pdf Form and Instruction
2880 Disclosure/Update Report 2880.pdf www.hud.gov/sites/dfiles/OCHCO/documents/2880.pdf Form and Instruction
2880 Disclosure/Update Report 2880.pdf www.hud.gov/sites/dfiles/OCHCO/documents/2880.pdf Form and Instruction
SF-424 Application for Federal Assistance SF-424 SF424_4_0-V4.0.pdf www.hud.gov/sites/dfiles/CPD/documents/SF424_4_0-V4.0.pdf Form and Instruction
SF-424 Application for Federal Assistance SF-424 SF424_4_0-V4.0.pdf www.hud.gov/sites/dfiles/CPD/documents/SF424_4_0-V4.0.pdf Form and Instruction
SFLLL DISCLOSURE OF LOBBYING ACTIVITIES SFLLL_2_0-V2.0.pdf www.hud.gov/sites/dfiles/CPD/documents/SFLLL_2_0-V2.0.pdf Form and Instruction
SFLLL DISCLOSURE OF LOBBYING ACTIVITIES SFLLL_2_0-V2.0.pdf www.hud.gov/sites/dfiles/CPD/documents/SFLLL_2_0-V2.0.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	At Risk Receivership/Substandard/Troubled Program	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	HUD-50075.1	Annual Statement/Performance and Evaluation Report	50075.1.pdf		Yes	Yes	Fillable Printable
Form and Instruction	424-b	Instructions for the HUD 424-B Assurances and Certifications	424-B.pdf	https://www.hud.gov/sites/dfiles/OCHCO/documents/424-B.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	2880	Disclosure/Update Report	2880.pdf	https://www.hud.gov/sites/dfiles/OCHCO/documents/2880.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	SF-424	Application for Federal Assistance SF-424	SF424_4_0-V4.0.pdf	https://www.hud.gov/sites/dfiles/CPD/documents/SF424_4_0-V4.0.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	SFLLL	DISCLOSURE OF LOBBYING ACTIVITIES	SFLLL_2_0-V2.0.pdf	https://www.hud.gov/sites/dfiles/CPD/documents/SFLLL_2_0-V2.0.pdf	Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 110	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	110	110
Annual IC Time Burden (Hours)	680	680
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.