Indian Housing Block Grants (IHBG) Program Reporting

Forms and Documents

Document	Type	Status	Availability
Form SF-425 Federal Financial Report	Form	Modified	Available
Form SF-424D Assurances and Construction Programs	Form	Modified	Repair queued
Form SF-424 Mandatory	Form	Modified	Available
Form HUD-2880 Applicant Recipient Disclosure Update Report	Form	Modified	Available
Form HUD-424B Assurances and Certifications	Form	Modified	Available
Form HUD 424B Assurances and Certifications	Form	Modified	Available
Form HUD 4123-4125 Combined Cost Summary	Form and Instruction	Modified	Repair queued
Form HUD-53246 Reference	Form and Instruction	Modified	Available
Form HUD-52736-B Depository Agreement - Brokers/Dealers	Form and Instruction	Modified	Repair queued
Form HUD-52736-A Depository Agreement - Banking Accounts	Form and Instruction	Modified	Available
Form HUD-4119 Challenging U.S. Census Data	Form	Modified	Repair queued
Form HUD-4119 Appendix Challenging Population Projections Data	Form	Modified	Available
Form HUD-4119 Appendix D	Form	Modified	Available
Form HUD-4119 Appendix C	Form	Modified	Repair queued
Form HUD-4119 Appendix B	Form	Modified	Repair queued
Form HUD-4117 Formula Response Form	Form and Instruction	Modified	Repair queued
Form HUD-4117 Appendices A-D	Form and Instruction	Modified	Repair queued
Form HUD-53247 Reference	Form and Instruction	Modified	Repair queued
Form HUD-52737 IHP APR Fillable	Form and Instruction	Modified	Repair queued
Form HUD-52737 IHP APR GEMS	Form and Instruction	Modified	Available
Form HUD-52737 Indian Housing Block Grants (IHBG) Program Reporting	Form and Instruction	Modified	Repair queued
OTN Written Comments IHBG 2577-0218.pdf	Public Comments	Uploaded 2025-07-25	Repair queued
30-Day FRN.pdf	Supplementary Document	Uploaded 2025-07-10	Repair queued
30-Day FRN.pdf	Supplementary Document	Uploaded 2025-07-10	Repair queued
2577-0218 IHBG 30-Day FRN pub 7-7-25.pdf	Supplementary Document	Uploaded 2025-07-08	Repair queued
2577-0218 IHBG 30-Day FRN pub 7-7-25.pdf	Supplementary Document	Uploaded 2025-07-08	Repair queued
Final -OMB 2577-0218 IHBG Supporting Statement.docx	Supporting Statement A	Uploaded 2025-07-01	Repair queued
Final -OMB 2577-0218 IHBG Supporting Statement.docx	Supporting Statement A	Uploaded 2025-07-01	Repair queued

IC Document Collections

IC ID	Collection	Type	Status	Form
27892	Indian Housing Block Grants (IHBG) Program Reporting	Form	Modified	Federal Financial Report
27892	Indian Housing Block Grants (IHBG) Program Reporting	Form	Modified	Assurances and Construction Programs
27892	Indian Housing Block Grants (IHBG) Program Reporting	Form	Modified	Mandatory
27892	Indian Housing Block Grants (IHBG) Program Reporting	Form	Modified	Applicant Recipient Disclosure Update Report
27892	Indian Housing Block Grants (IHBG) Program Reporting	Form	Modified	Assurances and Certifications
27892	Indian Housing Block Grants (IHBG) Program Reporting	Form	Modified	Assurances and Certifications
27892	Indian Housing Block Grants (IHBG) Program Reporting	Form and Instruction	Modified	Combined Cost Summary
27892	Indian Housing Block Grants (IHBG) Program Reporting	Form and Instruction	Modified	Reference
27892	Indian Housing Block Grants (IHBG) Program Reporting	Form and Instruction	Modified	Depository Agreement - Brokers/Dealers
27892	Indian Housing Block Grants (IHBG) Program Reporting	Form and Instruction	Modified	Depository Agreement - Banking Accounts
27892	Indian Housing Block Grants (IHBG) Program Reporting	Form	Modified	Challenging U.S. Census Data
27892	Indian Housing Block Grants (IHBG) Program Reporting	Form	Modified	Challenging Population Projections Data
27892	Indian Housing Block Grants (IHBG) Program Reporting	Form	Modified	Appendix D
27892	Indian Housing Block Grants (IHBG) Program Reporting	Form	Modified	Appendix C
27892	Indian Housing Block Grants (IHBG) Program Reporting	Form	Modified	Appendix B
27892	Indian Housing Block Grants (IHBG) Program Reporting	Form and Instruction	Modified	Formula Response Form
27892	Indian Housing Block Grants (IHBG) Program Reporting	Form and Instruction	Modified	Appendices A-D
27892	Indian Housing Block Grants (IHBG) Program Reporting	Form and Instruction	Modified	Reference
27892	Indian Housing Block Grants (IHBG) Program Reporting	Form and Instruction	Modified	IHP APR Fillable
27892	Indian Housing Block Grants (IHBG) Program Reporting	Form and Instruction	Modified	IHP APR GEMS
27892	Indian Housing Block Grants (IHBG) Program Reporting	Form and Instruction	Modified

ICR Details

OMB Control No: 2577-0218	ICR Reference No: 202504-2577-001
Status: Active	Previous ICR Reference No: 202105-2577-003
Agency/Subagency: HUD/PIH	Agency Tracking No: 2577-0218
Title: Indian Housing Block Grants (IHBG) Program Reporting
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/28/2026
Retrieve Notice of Action (NOA)	Date Received in OIRA: 07/10/2025
Terms of Clearance: This collection is approved for one year. Prior to reapproval of this information collection and preferably within six months of this approval, the agency will provide a substantive set of responses to OMB in response to the public commenter, expand on the discussion of the purpose of each instrument in the collection, and provide revised burden estimates if appropriate.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2027	36 Months From Approved	01/31/2026
Responses	441	0	3,341
Time Burden (Hours)	78,695	0	104,183
Cost Burden (Dollars)	0	0	0

---

Abstract: The forms included in this collection are associated with the Indian Housing Block Grant (IHBG) program, as authorized under Title I of the Native American Housing Assistance and Self-Determination Reauthorization Act (NAHASDA) (25 U.S.C. 4101). The IHBG program provides funding to eligible Native American tribes and tribally designated housing entities (TDHEs) in the form of formula-based allocations and competitive awards.

---

Authorizing Statute(s): US Code: 44 USC Chapter 35 as amended Name of Law: Section 3506 of the Paperwork Reduction Act of 1995
  

Citations for New Statutory Requirements: US Code: 44 USC Chapter 35 as amended Name of Law: Paperwork Reduction Act of 1995

---

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:
	90 FR 17611	04/28/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 29880	07/07/2025
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Indian Housing Block Grants (IHBG) Program Reporting	HUD-4119, HUD-4119, HUD-4119 Appendix A, HUD-4119, HUD-52736-A, HUD-52736-B, HUD-53246, HUD-52737, HUD-4119, HUD-52737, HUD-53247, HUD-4117, HUD-4117, HUD 4123-4125 , HUD 424B, HUD-424B, HUD-2880, SF-424 , SF-424D, SF-425	IHP APR GEMS ,   IHP APR Fillable ,   Reference ,   Appendices A-D ,   Formula Response Form ,   Appendix B ,   Appendix C ,   Appendix D ,   Challenging Population Projections Data ,   Challenging U.S. Census Data ,   Depository Agreement - Banking Accounts ,   Depository Agreement - Brokers/Dealers ,   Reference ,   Combined Cost Summary ,   Assurances and Certifications ,   Assurances and Certifications ,   Applicant Recipient Disclosure Update Report ,   Mandatory ,   Assurances and Construction Programs ,   Federal Financial Report

---

ICR Summary of Burden

	Total Approved	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	441	3,341	0	-2,900	0	0
Annual Time Burden (Hours)	78,695	104,183	0	-25,488	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: Yes

Burden Reduction Due to: Changing Forms

Short Statement: • This is a revision of currently approved collection. • HUD-4123: Cost Summary (OMB no: 2501-0044) replaced HUD-53246 • HUD-4125: Implementation Schedule (OMB no: 2501-0044) replaced HUD-53247 • Estimated hours per response for both respondents and reviewers were corrected; specifically for Formula forms HUD-4117 and 4119. While every grantee is provided with a HUD-4117, relatively few utilize it annually for requesting adjustments to formula data. Fewer utilize the HUD-4119 to challenge formula data. • Collection also makes clear the full burden associated with the grant life cycle.

---

Annual Cost to Federal Government: $3,264,858

Does this IC contain surveys, censuses, or employ statistical methods? No

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.     No

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: 07/10/2025

---