Information Collection

Household Services and Outcomes Submission Report 52698(a)

IC 272898 under ICR 202412-2528-004 · OMB 2528-0331.

Documents and Forms

Document Name Document Type
Household Services and Outcomes Submission Report_52698a.xlsx Other-Submission Report
Final - EOrev HUD-Form-52698a-Household-Services-and-Outcomes-Submission-Report.xlsx Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Household Services and Outcomes Submission Report 52698(a)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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
Instruction			Final - EOrev HUD-Form-52698a-Household-Services-and-Outcomes-Submission-Report.xlsx		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: 21	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	84	84
Annual IC Time Burden (Hours)	84	84
Annual IC Cost Burden (Dollars)	5,152	5,152

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.