Family Self-Sufficiency Program (FSS)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 50058 Family Repor MTW Family Report	Form and Instruction	Modified	Available
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	Available
Form SF-425 Federal Financial Report	Form and Instruction	Modified	Available
Form SF-424 Application for Federal Assistance	Form and Instruction	Modified	Available
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	Available
Comments from Anonymous Two June 16 2025.pdf	Public Comments	Uploaded 2025-09-03	Available
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

Information collection document groups

IC ID	Collection	Type	Status	Form
27844	Family Self-Sufficiency Program (FSS)	Form and Instruction	Modified	MTW Family Report
27844	Family Self-Sufficiency Program (FSS)	Form and Instruction	Modified	MTW Expaansion Family Report PH-HCV
27844	Family Self-Sufficiency Program (FSS)	Form and Instruction	Modified	Family Report HCV-Sec Moderate Rehabiliation Program
27844	Family Self-Sufficiency Program (FSS)	Instruction	Modified
27844	Family Self-Sufficiency Program (FSS)	Form and Instruction	Modified	FSS Annual Survey
27844	Family Self-Sufficiency Program (FSS)	Form and Instruction	Modified	FSS Monitoring Review Tool
27844	Family Self-Sufficiency Program (FSS)	Form and Instruction	Modified	Disclosure of Lobbying Activities
27844	Family Self-Sufficiency Program (FSS)	Form and Instruction	Modified	Federal Financial Report
27844	Family Self-Sufficiency Program (FSS)	Form and Instruction	Modified	Application for Federal Assistance
27844	Family Self-Sufficiency Program (FSS)	Form and Instruction	Modified	Applicant and Recipient Assurances and Certifications
27844	Family Self-Sufficiency Program (FSS)	Form and Instruction	Modified	Family Self-Sufficiency (FSS) Program Coordinator Funding
27844	Family Self-Sufficiency Program (FSS)	Form and Instruction	Modified	Applicant/Recipient Disclosure/Update Report
27844	Family Self-Sufficiency Program (FSS)	Form and Instruction	Modified	Family 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

ICR Details

OMB Control No: 2577-0178	ICR Reference No: 202508-2577-002
Status: Active	Previous ICR Reference No: 202009-2577-001
Agency/Subagency: HUD/PIH	Agency Tracking No: 2577-0178
Title: Family Self-Sufficiency Program (FSS)
Type of Information Collection: Reinstatement with change of a previously 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: 09/03/2025
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2029	36 Months From Approved
Responses	28,810	0	0
Time Burden (Hours)	39,520	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: 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.

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Authorizing Statute(s): PL: Pub.L. 101 - 625 23(c) Name of Law: National Affordable Housing Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 25070	06/13/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 42422	09/02/2025
Did the Agency receive public comments on this ICR? Yes

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

table that charts list of burden

IC Title	Form No.	Form Name
Family Self-Sufficiency Program (FSS)	HUD-52650, HUD-52651, HUD-2880, 424B, SF-424, SF-425, SFLLL, 52651-B, 52651-C, 50058 Family Report, 50058 MTW Expansion, 50058 Family Report	Family Self-Sufficiency (FSS) Program Contract of Participation - Housing Choice Voucher Public and Indian Housing Programs ,   Applicant/Recipient Disclosure/Update Report ,   Family Self-Sufficiency (FSS) Program Coordinator Funding ,   Applicant and Recipient Assurances and Certifications ,   Application for Federal Assistance ,   Federal Financial Report ,   Disclosure of Lobbying Activities ,   FSS Monitoring Review Tool ,   FSS Annual Survey ,   Family Report HCV-Sec Moderate Rehabiliation Program ,   MTW Expaansion Family Report PH-HCV ,   MTW Family Report

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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	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

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: 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.

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Annual Cost to Federal Government: $88,886

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? No

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Common Form ICR:  No

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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: 09/03/2025

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