Information Collection

Implementation of the Violaence Against Women Reathorization Act 2013

IC 224769 under ICR 202505-2577-001 · OMB 2577-0286.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form 5380
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
5380 Housing Rights for Victims
Final EOrev.2025.05.20 HUD-5380_clean.docx
Form
5380 Housing Rights for Victims
Final EOrev.2025.05.20 HUD-5380_clean.docx
Form
5381 MODEL EMERGENCY TRANSFER PLAN FOR VICTIMS OF DOMESTIC VI
Final EOrev.2025.05.20 HUD-5381_clean.docx
Form
5381 MODEL EMERGENCY TRANSFER PLAN FOR VICTIMS OF DOMESTIC VI
Final EOrev.2025.05.20 HUD-5381_clean.docx
Form
5382 CERTIFICATION OF DOMESTIC VIOLENCE, DATING VIOLENCE, SEX
Final EOrev.2025.05.20 HUD-5382_clean.docx
Form
5382 CERTIFICATION OF DOMESTIC VIOLENCE, DATING VIOLENCE, SEX
Final EOrev.2025.05.20 HUD-5382_clean.docx
Form
5383 EMERGENCY TRANSFER REQUEST FOR VICTIMS OF DOMESTIC VIOLE
Final EOrev.2025.05.20 HUD-5383_clean.docx
Form
5383 EMERGENCY TRANSFER REQUEST FOR VICTIMS OF DOMESTIC VIOLE
Final EOrev.2025.05.20 HUD-5383_clean.docx
Form
HUD-5384 VAWA ET Data Collection Form
Final.2025.05.20 HUD-5384_clean.docx
Form
HUD-5384 VAWA ET Data Collection Form
Final.2025.05.20 HUD-5384_clean.docx
Form

Information Collection (IC) Details

View Information Collection (IC)

layout table

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 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


table that charts list of burden
  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 5,044,764 0 0 0 0 5,044,764
Annual IC Time Burden (Hours) 2,230,481 0 0 0 0 2,230,481
Annual IC Cost Burden (Dollars) 0 0 0 0 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.
Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].