Information Collection

Implementation of the Violaence Against Women Reathorization Act 2013

IC 224769 under ICR 202501-2577-003 · OMB 2577-0286.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2577-0286 can be found here:

2025-05-20 - No material or nonsubstantive change to a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form HUD XXXX Implementation of the Violaence Against Women Reathorization Act 2013	Form
Form 5380 Housing Rights for Victims Implementation of the Violaence Against Women Reathorization Act 2013	Form
Form 5381 MODEL EMERGENCY TRANSFER PLAN FOR VICTIMS OF DOMESTIC VIOLENCE, DATING VIOLENCE, SEXUAL ASSAULT, OR STALKING Implementation of the Violaence Against Women Reathorization Act 2013	Form
Form 5382 CERTIFICATION OF DOMESTIC VIOLENCE, DATING VIOLENCE, SEXUAL ASSAULT, OR STALKING Implementation of the Violaence Against Women Reathorization Act 2013	Form
Form 5383 EMERGENCY TRANSFER REQUEST FOR VICTIMS OF DOMESTIC VIOLENCE, DATING VIOLENCE, SEXUAL ASSAULT, OR STALKING Implementation of the Violaence Against Women Reathorization Act 2013	Form
Form HUD-5384 VAWA ET Data Collection Form Implementation of the Violaence Against Women Reathorization Act 2013	Form
HUD XXXX VAWA EMERGENCY TRANSFER DATA COLLECTION FORM 2577-0286_VAWA_Doc_No#.docx	Form
HUD 5380 NOTICE OF OCCUPANCY RIGHTS UNDER THE VIOLENCE AGAINST WO 2024.11.26 HUD-5380_clean.docx	Form and Instruction
HUD 5381 MODEL EMERGENCY TRANSFER PLAN FOR VICTIMS OF DOMESTIC VI 2024.11.26 HUD-5381_clean.docx	Form and Instruction
HUD 5382 CERTIFICATION OF DOMESTIC VIOLENCE, DATING VIOLENCE, SEX 2024.11.26 HUD-5382_clean.docx	Form and Instruction
HUD 5383 EMERGENCY TRANSFER REQUEST FOR VICTIMS OF DOMESTIC VIOLE 2024.11.26 HUD-5383_clean.docx	Form and Instruction
5380 Housing Rights for Victims HUD-5380 Housing Rights for Victims (Final)5-14-25.docx	Form
5381 MODEL EMERGENCY TRANSFER PLAN FOR VICTIMS OF DOMESTIC VI Final EOrev2.HUDForm-5381.docx	Form
5382 CERTIFICATION OF DOMESTIC VIOLENCE, DATING VIOLENCE, SEX Final EOrev2.HUDForm-5382.docx	Form
5383 EMERGENCY TRANSFER REQUEST FOR VICTIMS OF DOMESTIC VIOLE Final EOrev2.HUDForm-5383.docx	Form
HUD-5384 VAWA ET Data Collection Form HUD 5384 VAWA ET Data Collection Form 5-14-25.docx	Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Implementation of the Violaence Against Women Reathorization Act 2013

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	5380	Yes	Yes	Fillable Fileable
Form	5381	Yes	Yes	Fillable Fileable
Form	5382	Yes	Yes	Fillable Fileable
Form	5383	Yes	Yes	Fillable Fileable
Form	HUD-5384	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 293,176

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 3 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	5,044,764	5,044,764
Annual IC Time Burden (Hours)	2,230,481	2,230,481
Annual IC Cost Burden (Dollars)	0	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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