Information Collection

VIOLENCE AGAINST WOMEN REAUTHORIZATION ACT (VAWA) Lease Addendum

IC 281820 under ICR 202502-2502-005 · OMB 2502-0178.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form HUD Form 91067 VIOLENCE AGAINST WOMEN REAUTHORIZATION ACT (VAWA) Lease Addendum VIOLENCE AGAINST WOMEN REAUTHORIZATION ACT (VAWA) Lease Addendum	Form and Instruction
HUD Form 91067 VIOLENCE AGAINST WOMEN REAUTHORIZATION ACT (VAWA) Lease Final - HUD Form 91067 VAWA Lease Addendum 8.6.26.docx	Form and Instruction

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: 24 CFR 5.2005(a)(4)

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 Form 91067				Yes	No	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Homeownership Promotion

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 413,929

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	413,929	413,929
Annual IC Time Burden (Hours)	53,811	53,811
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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