Information Collection

Implementation of the Violaence Against Women Reathorization Act 2013

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

Documents and Forms

Document Name Document 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)

IC Title:	Implementation of the Violaence Against Women Reathorization Act 2013	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	5380	Housing Rights for Victims	Final EOrev.2025.05.20 HUD-5380_clean.docx	Yes	Yes	Fillable Fileable
Form	5381	MODEL EMERGENCY TRANSFER PLAN FOR VICTIMS OF DOMESTIC VIOLENCE, DATING VIOLENCE, SEXUAL ASSAULT, OR STALKING	Final EOrev.2025.05.20 HUD-5381_clean.docx	Yes	Yes	Fillable Fileable
Form	5382	CERTIFICATION OF DOMESTIC VIOLENCE, DATING VIOLENCE, SEXUAL ASSAULT, OR STALKING	Final EOrev.2025.05.20 HUD-5382_clean.docx	Yes	Yes	Fillable Fileable
Form	5383	EMERGENCY TRANSFER REQUEST FOR VICTIMS OF DOMESTIC VIOLENCE, DATING VIOLENCE, SEXUAL ASSAULT, OR STALKING	Final EOrev.2025.05.20 HUD-5383_clean.docx	Yes	Yes	Fillable Fileable
Form	HUD-5384	VAWA ET Data Collection Form	Final.2025.05.20 HUD-5384_clean.docx	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 293,176	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 3 %

	Approved	Previously Approved
Annual Number of Responses for this IC	5,044,764	5,044,764
Annual IC Time Burden (Hours)	2,230,481	2,230,481
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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].