Information Collection

Household Services and Outcomes Report, 52698

IC 251335 under ICR 202412-2528-004 · OMB 2528-0331.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Final - HUD Form 52698 Eviction Protection Client Report.docx	Other-Client Services and Outcomes R
Household Services and Outcomes Report_52698.pdf	Other-reporting form
Final EOrevHUD 52698 Household Services and Outcomes Report.docx	Other-Client Reporting

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

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
Other-Client Reporting					No		Paper Only

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 21

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	21,000	1,000	20,000
Annual IC Time Burden (Hours)	5,250	250	5,000
Annual IC Cost Burden (Dollars)	321,983	321,983	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.

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