The Community Choice Demonstration

Forms and Documents

Document Name	Status
EOrev.Redline.Attachment M.2_The Obesity Type II Diabetes Risk Assessment_Survey_Follow-up.pdf Supplementary Document	2025-05-20
EOrev.Supporting Statement A.pdf Supplementary Document	2025-05-20
Final EOrev.Attachment M.1_The Obesity Type II Diabetes Risk Assessment_Survey_Baseline.docx Supplementary Document	2025-05-20
EOrev.Redline.Attachment L_The Child and MOVED Assessments_Consent.pdf Supplementary Document	2025-05-20
EOrev.Redline.Attachment I.2_The Child Assessment_Direct Child Assessment_Follow-up.pdf Supplementary Document	2025-05-20
EOrev.Redline.Attachment I.1_The Child Assessment_Direct Child Assessment_Baseline.pdf Supplementary Document	2025-05-20
EOrev.Redline.Attachment G_The Child Assessment & The Obesity and Type II Diabetes Risk Assessment_Assent.pdf Supplementary Document	2025-05-20
EOrev.Form Revision Chart Template.docx Justification for No Material/Nonsubstantive Change	2025-05-20
EOrev.Redline.Attachment G Mobility Services Tracking Tool.pdf Supplementary Document	2025-05-20
30-Day Notice The Community Choice Demonstration.pdf Supplementary Document	2023-10-19
Evaluation of the Community Choice Demonstration 60-Day Notice.pdf Supplementary Document	2023-10-19
Supporting Statement B.docx Supporting Statement B	2023-12-14
Final EOrev.Supporting Statement A.docx Supporting Statement A	2025-04-18

IC Document Collections

IC ID	Document Title	Status
266091	PHASE 2- OTHER ADULT HOUSEHOLD MEMBER INFORMED CONSENT FOR STUDY PARTICIPATION Other-Revised - Attachment P Phase 2 Other Adult Household Membe	Unchanged
266090	PHASE 2- HEAD OF HOUSEHOLD WAITLIST FAMILY INFORMED CONSENT FOR STUDY PARTICIPATION Other-Revised - Attachment O Phase 2 Head of Household Waitlist	Unchanged
266089	PHASE 2- HEAD OF HOUSEHOLD EXISTING VOUCHER FAMILY INFORMED CONSENT FOR STUDY PARTICIPATION Other-Revised - Attachment N Phase 2 HoH Existing Voucher Holder	Unchanged
266088	PHASE 1- HEAD OF HOUSEHOLD EXISTING VOUCHER FAMILY INFORMED CONSENT FOR STUDY PARTICIPATION Other-Revised - Attachment B Head of Household Existing Voucher	Unchanged
266087	PHA STAFF INTERVIEW GUIDE Other-Revised - Instrument 3 PHA Staff Interview Guide	Unchanged
266086	PARENT/GUARDIAN PERMISSION FORM Other-Revised - Attachment E Parent Guardian Permission Form	Unchanged
266085	OTHER ADULT HOUSEHOLD MEMBER INFORMED CONSENT FOR STUDY PARTICIPATION Other-Revised - Attachment D Other Adult Household Member Inform	Unchanged
266084	Mobility Services Tracking Tool Evaluation of the Housing Choice Voucher Mobility Demonstration Other-Revised - Attachment G Mobility Services Tracking Tool	Modified
266083	Mobility Services Provider Interview Outreach Evaluation of the Housing Choice Voucher Mobility Demonstration Other-Revised - Attachment K Mobility Services Provider Intervie	Unchanged
266082	MOBILITY SERVICES PROVIDERS INTERVIEW GUIDE Other-Revised - Instrument 4 Mobility Services Provider Intervie	Unchanged
266081	Landlord Interview Advance Letter Evaluation of the Housing Choice Voucher Mobility Demonstration Other-Revised - Attachment L Landlord Interview Advance Letter	Unchanged
266080	INTERVIEW GUIDE FOR PARTICIPATING FAMILIES WHO HAVE LEASED UP Other-Revised - Instrument 6 Interview Guide for Leased Up Famil	Unchanged
266079	INTERVIEW GUIDE FOR PARTICIPATING FAMILIES CURRENTLY SEARCHING FOR HOUSING Other-Revised - Instrument 5 Interview Guide for Searching Famil	Unchanged
266078	INTERVIEW GUIDE FOR OPPORTUNITY AREA LANDLORDS Other-Revised - Instrument 7 Interview Guide for Participating L	Unchanged
266060	Head of Household Family Interview Email Reminder Evaluation of the Housing Choice Voucher Mobility Demonstration Other-Revised - Attachment J Family Interview Email Reminder	Unchanged
266059	Head of Household Family Interview Advance Letter Evaluation of the Housing Choice Voucher Mobility Demonstration Other-Revised - Attachment I Family Interview Advance Letter	Unchanged
266058	HOUSEHOLD ROSTER AND BASELINE INFORMATION FORM Other-Revised - Instrument 1 Household Roster and Baseline Infor	Unchanged
266057	HEAD OF HOUSEHOLD WAITLIST FAMILY INFORMED CONSENT FOR STUDY PARTICIPATION Other-Revised - Attachment C Head of Household Waitlist Family I	Unchanged
266056	HEAD OF HOUSEHOLD FAMILY INTERVIEW CONSENT FORM Other-Revised - Attachment H Head of Household Family Interview	Unchanged
266055	COST STUDY DATA COLLECTION OUTREACH Other-Revised - Attachment M Cost Interview Advance Letter	Unchanged
266054	COST DATA COLLECTION INTERVIEW GUIDE Other-Revised - Instrument 8 Interview Guide for Cost Data Colle	Unchanged
266053	BASELINE SURVEY Other-Revised - Instrument 2 HCV Mobility Evaluation Baseline Su	Unchanged
262928	Tracking Calls Other-Tracking Calls	Unchanged
262927	Tracking Emails/Texts Other-Tracking Emails/Texts	Unchanged
262926	Semi-Structured Interviews Other-Semi-Structured Interviews	Unchanged
262925	Consent for Semi-Structured Interviews Other-Consent for Semi-Structured Interviews	Unchanged
262924	Blood Pressure Reading (adult) Other-Blood Pressure Reading (adult)	Unchanged
262922	Accelerometers (child) Other-Accelerometers (child)	Unchanged
262921	Accelerometers (adult) Other-Accelerometers (adult)	Unchanged
262919	Home Observations/ Housing Assessment Other-Home Observations/ Housing Assessment	Unchanged
262916	Blood Spot Samples (adult) Other-Blood Spot Samples (adult)	Unchanged
262915	Anthropometric assessments (child, but accounting for parent's time) Other-Anthropometric assessments (child, but accounting for pare	Unchanged
262912	Anthropometric assessments (child) Other-Anthropometric assessments (child)	Unchanged
262910	Anthropometric assessments (adult) Other-Anthropometric assessments (adult)	Unchanged
262909	Adult Survey Other-Adult Survey	Modified
262906	Consent for Assessment Other-Consent for Assessment	Modified
262905	Follow-up Call Phone Script Other-Follow-up Call Phone Script	Unchanged
262904	Email Reminder Other-Email Reminder	Unchanged
262902	Advance Letter Other-Advance Letter	Unchanged
262901	Direct Child Assessment Other-Direct Child Assessment	Modified
262900	Survey about child (asked of parent/guardian) and parent/guardian's presence during direct Child Assessment Other-Survey about child (asked of parent/guardian) and parent/g	Unchanged
262899	Consent for Assessment Other-Consent for Assessment	Modified
262898	Survey Other-Survey	Unchanged
262897	Interviewer Observations Other-Interviewer Observations	Unchanged
262892	Direct Measurements Other-Direct Measurements	Unchanged
262891	Consent for Assessment Other-Consent for Assessment	Unchanged
262890	Follow-up Call Phone Script Other-Follow-up Call Phone Script	Unchanged
262889	Email Reminder Other-Email Reminder	Unchanged
262887	Advance Letter Other-Advance Letter	Unchanged

ICR Details

OMB Control No: 2528-0337	ICR Reference No: 202502-2528-005
Status: Received in OIRA	Previous ICR Reference No: 202410-2528-002
Agency/Subagency: HUD/PD&R	Agency Tracking No:
Title: The Community Choice Demonstration
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 05/20/2025

	Requested	Previously Approved
Expiration Date	12/31/2026	12/31/2026
Responses	144,767	144,767
Time Burden (Hours)	313,582	313,582
Cost Burden (Dollars)	0	0

---

Abstract: The Office of Policy Development and Research (PD&R), at the U.S. Department of Housing and Urban Development (HUD), is seeking approval to collect additional information of individuals participating in the Community Choice Demonstration (formerly known as the Housing Choice Voucher Mobility Demonstration) (“Demonstration” for short). The instruments required for the implementation and early phase of the evaluation of the Demonstration were originally approved by the OMB in May and June 2022. Approval was granted under OMB Control #2528-0337 and expires June 30, 2025.

---

Authorizing Statute(s): US Code: 12 USC 1701z-1 Name of Law: Research and Demonstrations
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 40841	06/22/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 71594	10/17/2023
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 49

IC Title	Form No.	Form Name
Head of Household Family Interview Advance Letter Evaluation of the Housing Choice Voucher Mobility Demonstration
Accelerometers (adult)
Accelerometers (child)
Adult Survey
Advance Letter
Advance Letter
Anthropometric assessments (adult)
Anthropometric assessments (child)
Anthropometric assessments (child, but accounting for parent's time)
BASELINE SURVEY
Blood Pressure Reading (adult)
Blood Spot Samples (adult)
COST DATA COLLECTION INTERVIEW GUIDE
COST STUDY DATA COLLECTION OUTREACH
Consent for Assessment
Consent for Assessment
Consent for Assessment
Consent for Semi-Structured Interviews
Direct Child Assessment
Direct Measurements
Email Reminder
Email Reminder
Follow-up Call Phone Script
Follow-up Call Phone Script
HEAD OF HOUSEHOLD FAMILY INTERVIEW CONSENT FORM
HEAD OF HOUSEHOLD WAITLIST FAMILY INFORMED CONSENT FOR STUDY PARTICIPATION
HOUSEHOLD ROSTER AND BASELINE INFORMATION FORM
Head of Household Family Interview Email Reminder Evaluation of the Housing Choice Voucher Mobility Demonstration
Home Observations/ Housing Assessment
INTERVIEW GUIDE FOR OPPORTUNITY AREA LANDLORDS
INTERVIEW GUIDE FOR PARTICIPATING FAMILIES CURRENTLY SEARCHING FOR HOUSING
INTERVIEW GUIDE FOR PARTICIPATING FAMILIES WHO HAVE LEASED UP
Interviewer Observations
Landlord Interview Advance Letter Evaluation of the Housing Choice Voucher Mobility Demonstration
MOBILITY SERVICES PROVIDERS INTERVIEW GUIDE
Mobility Services Provider Interview Outreach Evaluation of the Housing Choice Voucher Mobility Demonstration
Mobility Services Tracking Tool Evaluation of the Housing Choice Voucher Mobility Demonstration
OTHER ADULT HOUSEHOLD MEMBER INFORMED CONSENT FOR STUDY PARTICIPATION
PARENT/GUARDIAN PERMISSION FORM
PHA STAFF INTERVIEW GUIDE
PHASE 1- HEAD OF HOUSEHOLD EXISTING VOUCHER FAMILY INFORMED CONSENT FOR STUDY PARTICIPATION
PHASE 2- HEAD OF HOUSEHOLD EXISTING VOUCHER FAMILY INFORMED CONSENT FOR STUDY PARTICIPATION
PHASE 2- HEAD OF HOUSEHOLD WAITLIST FAMILY INFORMED CONSENT FOR STUDY PARTICIPATION
PHASE 2- OTHER ADULT HOUSEHOLD MEMBER INFORMED CONSENT FOR STUDY PARTICIPATION
Semi-Structured Interviews
Survey
Survey about child (asked of parent/guardian) and parent/guardian's presence during direct Child Assessment
Tracking Calls
Tracking Emails/Texts

---

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	144,767	144,767	0	0	0	0
Annual Time Burden (Hours)	313,582	313,582	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $2,113,333

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 05/20/2025

---