Information Collection Request

Family Self-Sufficiency Program (FSS)

ICR 202508-2577-002 · OMB 2577-0178 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form 50058 Family Repor MTW Family Report Form and Instruction Modified Repair queued
Form 50058 MTW Expansio MTW Expaansion Family Report PH-HCV Form and Instruction Modified Available
Form 50058 Family Repor Family Report HCV-Sec Moderate Rehabiliation Program Form and Instruction Modified Available
Form 52651-C FSS Annual Survey Form and Instruction Modified Available
Form 52651-B FSS Monitoring Review Tool Form and Instruction Modified Repair queued
Form SFLLL Disclosure of Lobbying Activities Form and Instruction Modified Repair queued
Form SF-425 Federal Financial Report Form and Instruction Modified Available
Form SF-424 Application for Federal Assistance Form and Instruction Modified Repair queued
Form 424B Applicant and Recipient Assurances and Certifications Form and Instruction Modified Available
Form HUD-52651 Family Self-Sufficiency (FSS) Program Coordinator Funding Form and Instruction Modified Available
Form HUD-2880 Applicant/Recipient Disclosure/Update Report Form and Instruction Modified Available
Form HUD-52650 Family Self-Sufficiency (FSS) Program Contract of Participation - Housing Choice Voucher Public and Indian Housing Programs Form and Instruction Modified Available
Form HUD-52650 Family Self-Sufficiency Program (FSS) Form and Instruction Modified Repair queued
Comments from Anonymous Three June 16 2025.pdf Public Comments Uploaded 2025-09-03 Repair queued
Comments from Anonymous Two June 16 2025.pdf Public Comments Uploaded 2025-09-03 Repair queued
Comments from Anonymous One August 12 2025.pdf Public Comments Uploaded 2025-09-03 Available
Comments from Donald Faulkner - June 16 2025.pdf Public Comments Uploaded 2025-09-03 Available
Final-OMB 2577-0178 FSS Supp Stmt.docx Supporting Statement A Uploaded 2025-09-03 Available
Final-OMB 2577-0178 FSS Supp Stmt.docx Supporting Statement A Uploaded 2025-09-03 Repair queued
2577-0178 published 30-day FSS.pdf Supplementary Document Uploaded 2025-09-03 Repair queued
2577-0178 published 30-day FSS.pdf Supplementary Document Uploaded 2025-09-03 Repair queued
2577-0178 published 60-day FSS.pdf Supplementary Document Uploaded 2025-08-15 Repair queued
2577-0178 published 60-day FSS.pdf Supplementary Document Uploaded 2025-08-15 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
27844 Family Self-Sufficiency Program (FSS) Form and Instruction ModifiedMTW Family Report
27844 Family Self-Sufficiency Program (FSS) Form and Instruction ModifiedMTW Expaansion Family Report PH-HCV
27844 Family Self-Sufficiency Program (FSS) Form and Instruction ModifiedFamily Report HCV-Sec Moderate Rehabiliation Program
27844 Family Self-Sufficiency Program (FSS) Form and Instruction ModifiedFSS Annual Survey
27844 Family Self-Sufficiency Program (FSS) Form and Instruction ModifiedFSS Monitoring Review Tool
27844 Family Self-Sufficiency Program (FSS) Form and Instruction ModifiedDisclosure of Lobbying Activities
27844 Family Self-Sufficiency Program (FSS) Form and Instruction ModifiedFederal Financial Report
27844 Family Self-Sufficiency Program (FSS) Form and Instruction ModifiedApplication for Federal Assistance
27844 Family Self-Sufficiency Program (FSS) Form and Instruction ModifiedApplicant and Recipient Assurances and Certifications
27844 Family Self-Sufficiency Program (FSS) Form and Instruction ModifiedFamily Self-Sufficiency (FSS) Program Coordinator Funding
27844 Family Self-Sufficiency Program (FSS) Form and Instruction ModifiedApplicant/Recipient Disclosure/Update Report
27844 Family Self-Sufficiency Program (FSS) Form and Instruction ModifiedFamily Self-Sufficiency (FSS) Program Contract of Participation - Housing Choice Voucher Public and Indian Housing Programs
27844 Family Self-Sufficiency Program (FSS) Form and Instruction Modified
27844 Family Self-Sufficiency Program (FSS) Instruction Modified
ICR Details
2577-0178 202508-2577-002
Active 202009-2577-001
HUD/PIH 2577-0178
Family Self-Sufficiency Program (FSS)
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 01/28/2026
Retrieve Notice of Action (NOA) 09/03/2025
  Inventory as of this Action Requested Previously Approved
01/31/2029 36 Months From Approved
28,810 0 0
39,520 0 0
0 0 0

Housing agencies enter into a Contract of Participation with each eligible family that opts to participate in the program; consult with local officials to develop an Action Plan; and report annually to HUD on implementation of the FSS program. PHAs may apply for funding to pay the salary (including fringe benefits) of FSS program coordinators.

PL: Pub.L. 101 - 625 23(c) Name of Law: National Affordable Housing Act
  
None

Not associated with rulemaking

  90 FR 25070 06/13/2025
90 FR 42422 09/02/2025
Yes

  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 28,810 0 0 28,070 0 740
Annual Time Burden (Hours) 39,520 0 0 -27,730 0 67,250
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes
Changing Forms
Reinstatement with changes of previously approved collection for which approval has expired The numbers are based on the following assumptions. The numbers have increased due to increased funding. The requirements have not changed. • Annual Applications/Grantees – 1000 o PIH Applications/Grantees – 800 o MF Applications/Grantees – 200 • Future new grantees – 200 • New Cooperative Agreements each year 250 • New participants each year 25,000 • Total participants each year 100,000 o PIH participants 80,000 o MF participants 20,000 • All applicants submit an SF-424, HUD-424B, HUD-52651 and a HUD-2880. They submit an SF-LLL if applicable. We may have a narrative for all applicants in the future. • All new grantees submit an FSS Action Plan • Every new participant requires a HUD-52650 Contract of Participation • Every PIH participant is reported on the HUD-50058 (or HUD-50058-MTW or HUD-50058-MTW Expansion). Since there is no FSS Addendum on the HUD-50059, we don’t use it. Instead, PBRA owners submit one PBRA FSS Reporting Tool (HUD-52653) each year. • Every FSS program will complete an Annual Survey once per year. • PIH will conduct a monitoring review of each program once every five years.

$88,886
No
    No
    No
No
No
No
No
Anice Chenault 502 618-8163

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
09/03/2025