OMB control number

Implementation of the Violence Against Women Reauthorization Act of 2013

OMB 2577-0286 · HUD/PIH.

OMB 2577-0286

The Violence Against Women Reauthorization Act of 2013 (“VAWA”) protects qualified tenants, participants, applicants, and affiliated individuals in all HUD-covered housing programs, who are victims of domestic violence, dating violence, sexual assault, or stalking. On November 16, 2016, HUD published a final rule (VAWA Rule) at 81 FR 80724, implementing VAWA’s provisions in its housing programs. The VAWA Rule includes the following Appendices, which entail certain reporting and recordkeeping burdens: (A) Notice of Occupancy Rights Under the Violence Against Women Act; (B) Model Emergency Transfer Plan for Victims of Domestic Violence, Dating Violence, Sexual Assault, or Stalking; (C) Certification of Domestic Violence, Dating Violence, Sexual Assault, or Stalking, and Alternate Documentation; and (D) Emergency Transfer Request for Certain Victims of Domestic Violence, Dating Violence, Sexual Assault, or Stalking. Under the VAWA Rule, PHAs, owners, and managers (collectively “Covered Housing Providers” or “CHPs”) Under the VAWA Rule, each CHP must make use of Appendix A and Appendix C, by providing copies of the Notice of Occupancy Rights and the Certification form. Each CHP presented with a claim for continued or initial tenancy or assistance, based on the victim’s status as a victim of domestic violence, dating violence, sexual assault, or stalking, may request that the victim document or provide written evidence to demonstrate that the violence occurred, and Certification form is one such way of documenting the violence. Each CHP must also establish an emergency transfer plan, although it need not be modeled on Appendix B. CHPs’ use of an Emergency Transfer Request form, like the model in Appendix D, is also discretionary. CHPs must track and report annually to HUD if they have any Emergency Transfer Requests and outcomes. Finally, under the VAWA Rule, CHPs may opt to provide a lease bifurcation to VAWA-covered individuals.

The latest form for Implementation of the Violence Against Women Reauthorization Act of 2013 expires 2028-01-31 and is listed under ICR 202505-2577-001.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form HUD-5384 VAWA ET Data Collection FormForm
Form 5383 EMERGENCY TRANSFER REQUEST FOR VICTIMS OF DOMESTIC VIOLENCE, DATING VIOLENCE, SEXUAL ASSAULT, OR STALKINGForm
Form 5382 CERTIFICATION OF DOMESTIC VIOLENCE, DATING VIOLENCE, SEXUAL ASSAULT, OR STALKINGForm
Form 5381 MODEL EMERGENCY TRANSFER PLAN FOR VICTIMS OF DOMESTIC VIOLENCE, DATING VIOLENCE, SEXUAL ASSAULT, OR STALKINGForm
Form 5380 Housing Rights for VictimsForm
Form 5380 Implementation of the Violaence Against Women Reathorization Act 2013Form
2025.05.19 VAWA Forms Revision Chart.pdfJustification for No Material/Nonsubstantive Change
2025.05.19 VAWA Forms Revision Chart.pdf Justification for No Material/Nonsubstantive Change
2025.05.20 HUD-5384_redline.pdfJustification for No Material/Nonsubstantive Change
2025.05.20 HUD-5384_redline.pdf Justification for No Material/Nonsubstantive Change
2025.05.20 HUD-5383_redline.pdfJustification for No Material/Nonsubstantive Change
2025.05.20 HUD-5383_redline.pdf Justification for No Material/Nonsubstantive Change
2025.05.20 HUD-5382_redline.pdfJustification for No Material/Nonsubstantive Change
2025.05.20 HUD-5382_redline.pdf Justification for No Material/Nonsubstantive Change
2025.05.20 HUD-5381_redline.pdfJustification for No Material/Nonsubstantive Change
2025.05.20 HUD-5381_redline.pdf Justification for No Material/Nonsubstantive Change
2025.05.20 HUD-5380_redline.pdfJustification for No Material/Nonsubstantive Change
2025.05.20 HUD-5380_redline.pdf Justification for No Material/Nonsubstantive Change
30 day frn VAWA.pdfSupplementary Document
30 day frn VAWA.pdf Supplementary Document
2577-0286 VAWA 60-day FRN.pdfSupplementary Document
2577-0286 VAWA 60-day FRN.pdf Supplementary Document
2577-0286_VAWA_SuppStateA.docxSupporting Statement A
2577-0286_VAWA_SuppStateA.docxSupporting Statement A
Implementation of the Violaence Against Women Reathorization Act 2013 Form
Implementation of the Violaence Against Women Reathorization Act 2013 Form
Implementation of the Violaence Against Women Reathorization Act 2013 Form
Implementation of the Violaence Against Women Reathorization Act 2013 Form
Implementation of the Violaence Against Women Reathorization Act 2013 Form
Implementation of the Violaence Against Women Reathorization Act 2013 Form