Information Collection

Annual Contributions Contract (ACC)

IC 272341 under ICR 202408-2577-004 · OMB 2577-0075.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form HUD 53012 Annual Contributions Contract (ACC)	Form
Form HUD 53012 Annual Contributions Contract Annual Contributions Contract (ACC)	Form
HUD 53012 Annual Contributions Contract 53012 (1).docx	Form
HUD 53012 Annual Contributions Contract Final - HUD Form 53012 Annual Contributions Contract.docx	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 2 CFR 200

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	HUD 53012				Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title: ACC

FR Citation: 88 FR 7076

Number of Respondents: 42

Number of Respondents for Small Entity: 42

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	42	42
Annual IC Time Burden (Hours)	42	42
Annual IC Cost Burden (Dollars)	1,890	1,890

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.

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