Homeowner Assistance Fund

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Annual Report User Guide	Form and Instruction	Modified	Repair queued
Guidance on Participant Compliance and Reporting Responsibilities	Form and Instruction	Modified	Repair queued
Annual Performance Report	Form and Instruction	Unchanged	Available
Quarterly Report	Form and Instruction	Modified	Repair queued
Quarterly Compliance Report – DHHL or	Form and Instruction	Unchanged	Repair queued
Quarterly Report	Form and Instruction	Modified	Available
$5M Allocation	Form and Instruction	Unchanged	Repair queued
ASSURANCES OF COMPLIANCE WITH CIVIL RIGHTS REQUIREMENTS	Form and Instruction	Unchanged	Available
HAF Title VI Assurances	Form and Instruction	Unchanged	Repair queued
Recipient Payment Information Form	Form and Instruction	Unchanged	Repair queued
Recipient Payment Information Form	Form and Instruction	Unchanged	Repair queued
Notice of Funds Request	Form and Instruction	Unchanged	Repair queued
Notice of Funds Request Form	Form and Instruction	Unchanged	Repair queued
Acceptance of Award Terms Form	Form and Instruction	Unchanged	Repair queued
Acceptance of Award Terms Form	Form and Instruction	Unchanged	Repair queued
EO 14168 Updates Key - May 2025.docx	Supplementary Document	Uploaded 2025-05-23	Available
EO 14168 Updates Key - May 2025.docx	Supplementary Document	Uploaded 2025-05-23	Repair queued
1505-0269 Non-substantive Change Request Justification (EO 14168).docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-05-23	Repair queued
1505-0269 Non-substantive Change Request Justification (EO 14168).docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-05-23	Repair queued
HAF Justification for Nonsubstantive Change - Financial Closeout 2024.03.13.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-03-26	Repair queued
HAF Justification for Nonsubstantive Change - Financial Closeout 2024.03.13.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-03-26	Repair queued
HAFReportingGuidance_PublicCommentsLog_4.26.22.pdf	Supplementary Document	Uploaded 2022-04-26	Repair queued
HAFReportingGuidance_PublicCommentsLog_4.26.22.pdf	Supplementary Document	Uploaded 2022-04-26	Repair queued
1505-0269 HAF Supporting Statement 2022-05-20.docx	Supporting Statement A	Uploaded 2022-06-01	Available
1505-0269 HAF Supporting Statement 2022-05-20.docx	Supporting Statement A	Uploaded 2022-06-01	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
253241	Annual Performance Report	Instruction	Modified
253241	Annual Performance Report	Form and Instruction	Modified	Annual Report User Guide
253241	Annual Performance Report	Form and Instruction	Modified	Guidance on Participant Compliance and Reporting Responsibilities
253241	Annual Performance Report	Form and Instruction	Unchanged
253238	Quarterly Compliance Report – DHHL or <$5M Allocation	Form and Instruction	Modified	Quarterly Report
253238	Quarterly Compliance Report – DHHL or	Form and Instruction	Unchanged
253086	Quarterly Compliance Report – State or >$5M Allocation	Form and Instruction	Modified	Quarterly Report
253086	$5M Allocation	Form and Instruction	Unchanged
248644	HAF Term Sheet - sample	Other-sample	Unchanged
248510	Grantee Plan Templates	Other-template	Unchanged
247619	HAF Title VI Assurances	Form and Instruction	Unchanged	ASSURANCES OF COMPLIANCE WITH CIVIL RIGHTS REQUIREMENTS
247619	HAF Title VI Assurances	Form and Instruction	Unchanged
246805	Recipient Payment Information Form	Form and Instruction	Unchanged	Recipient Payment Information Form
246805	Recipient Payment Information Form	Form and Instruction	Unchanged
246804	Notice of Funds Request Form	Form and Instruction	Unchanged	Notice of Funds Request
246804	Notice of Funds Request Form	Form and Instruction	Unchanged
246803	Acceptance of Award Terms Form	Form and Instruction	Unchanged	Acceptance of Award Terms Form
246803	Acceptance of Award Terms Form	Form and Instruction	Unchanged

ICR Details

OMB Control No: 1505-0269	ICR Reference No: 202505-1505-002
Status: Historical Active	Previous ICR Reference No: 202403-1505-005
Agency/Subagency: TREAS/DO	Agency Tracking No:
Title: Homeowner Assistance Fund
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 06/13/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/23/2025
Terms of Clearance: New IC documents uploaded during OIRA review.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2025	07/31/2025	07/31/2025
Responses	5,409	0	5,409
Time Burden (Hours)	7,478	0	7,478
Cost Burden (Dollars)	0	0	0

---

Abstract: On March 11, 2021, the President signed the American Rescue Plan Act of 2021 (the “Act”), Pub. L. No. 117-2. Title III, Subtitle B, Section 3206 of the Act established the Homeowner Assistance Fund and provides $9.961 billion for the U.S. Department of the Treasury (Treasury) to make payments to States (defined to include the District of Columbia, Puerto Rico, U.S. Virgin Islands, Guam, Northern Mariana Islands, and American Samoa), Indian tribes or tribally designated housing entities, as applicable, and the Department of Hawaiian Home Lands (collectively the “eligible entities”) to mitigate financial hardships associated with the coronavirus pandemic, including for the purposes of preventing homeowner mortgage delinquencies, defaults, foreclosures, loss of utilities or home energy services, and displacements of homeowners experiencing financial hardship after January 21, 2020, through qualified expenses related to mortgages and housing. Section 3206(c)(1) requires the eligible entities to use the funds for the purpose of preventing homeowner mortgage delinquencies, defaults, foreclosures, loss of utilities or home energy services, and displacements of homeowners experiencing financial hardship after January 21, 2020, through qualified expenses related to mortgages and housing. Section 3206(e)(1) provides that not later than 45 days after March 11, 2021, the Secretary shall pay each eligible entity. To date, eligible entities have generally received 10% of their allocations.

---

Authorizing Statute(s): PL: Pub.L. 117 - 2 3206 Name of Law: American Rescue Plan Act of 2021
  

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:
	87 FR 16557	03/23/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 32507	05/31/2022
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 9

table that charts list of burden

IC Title	Form No.	Form Name
Acceptance of Award Terms Form	n/a	Acceptance of Award Terms Form
Annual Performance Report	n/a, n/a	Guidance on Participant Compliance and Reporting Responsibilities ,   Annual Report User Guide
Grantee Plan Templates
HAF Term Sheet - sample
HAF Title VI Assurances	n/a	ASSURANCES OF COMPLIANCE WITH CIVIL RIGHTS REQUIREMENTS
Notice of Funds Request Form	n/a	Notice of Funds Request
Quarterly Compliance Report – DHHL or <$5M Allocation	n/a	Quarterly Report
Quarterly Compliance Report – State or >$5M Allocation	n/a	Quarterly Report
Recipient Payment Information Form	n/a	Recipient Payment Information Form

---

ICR Summary of Burden

table that charts list 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	5,409	5,409	0	0	0	0
Annual Time Burden (Hours)	7,478	7,478	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: The Interim Report burden hours have been removed since the Interim Report was a one-time report, which occurred in February 2022. This reduces the burden by 112 hours due to agency discretion.

---

Annual Cost to Federal Government: $2,984,774

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.     No

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? Yes

---

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: 05/23/2025

---