Information Collection

Pih-icdbg

IC 271377 under ICR 202412-2501-006 · OMB 2501-0044.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form HUD-4123 and HUD-4 PIH-ICDBG	Form and Instruction
Form HUD-4123 and HUD-4 Cost Summary (4123) and Implementation Schedule (4125) PIH-ICDBG	Form and Instruction
Child ICR 9.30.24.docx	Other-Pre-Award NOFO Activities
Child ICR 9.30.24.docx	Other-Pre-Award NOFO Activities
HUD-4123 and HUD-4 Cost Summary (4123) and Implementation Schedule (4125) Final Combined ICDBG IHBG Form 4123 and Form 4125.xlsx	Form and Instruction
HUD-4123 and HUD-4 Cost Summary (4123) and Implementation Schedule (4125) Final Combined ICDBG IHBG Form 4123 and Form 4125.xlsx	Form and Instruction
ICDBG-NOFO_FR-6800-N-23.pdf NOFO	IC Document
ICDBG-NOFO_FR-6800-N-23.pdf NOFO	IC Document

IC Title:

PIH-ICDBG

Agency IC Tracking Number:

2024-PIH-PRA-374

IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 24 CFR 1003

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-4123 and HUD-4125				Yes	Yes	Fillable Fileable
Other-Pre-Award NOFO Activities					No		Printable Only

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 300

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	Previously Approved
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	38,100	38,100
Annual IC Cost Burden (Dollars)	13,065	13,065

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
NOFO		10/04/2024

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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