Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Owner's Certification with HUD Tenant Eligibility and Rent Procedures
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
24 CFR Part 5
24 CFR 891 Subpart E
24 CFR 880
24 CFR 886
24 CFR 884
(To search for a specific CFR, visit the
Code of Federal Regulations.
)
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
9887/9887A
Notice and Consent for the Release of Information/Fact Sheet Verification of Information
9887.pdf
Yes
No
Fillable Printable
Form
HUD 90100
Annual Recertification
HUD-90100.doc
Yes
Yes
Fillable Fileable
Form
HUD 90101
Certificaiton for Qualified Long-Term Care Insurance Expenses
HUD-90101.doc
Yes
Yes
Fillable Printable
Form
HUD 90104
Exception to Limitations on Admission of Families
HUD-90104.doc
Yes
Yes
Fillable Fileable
Form and Instruction
HUD 27061-h
Race and Ethnic Reporting Form
HUD-27061-h.doc
Yes
No
Fillable Printable
Form and Instruction
HUD 90102
Sample Verification of Disability
90102.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
HUD 90103
Sample Verificaiton of disability All Programs
90103.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
HUD 50059
Owner's Certification of Compliance with HUD's Tenant Eligibility and Rent Procedures
50059.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
HUD 50059 A
Owner's Certification of Compliance - Partial Certificaiton
50059-A.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
HUD 90106
Appendix 5 - Sample Move-In/Move Out Inspection Form
90106.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
HUD 90067
Lease Addendum
Form 90067 Lease Addendum.doc
Yes
Yes
Fillable Fileable
Form and Instruction
HUD 90066
Certificaiton of Domestic Violence, Dating Violence or Stalking
HUD-90066_.doc
Yes
No
Fillable Printable
Form and Instruction
HUD 90105a
Model Lease for Subsidized Programs
HUD90105a _.doc
Yes
Yes
Fillable Fileable
Form and Instruction
HUD 90105b
Model Lease
HUD90105b_.doc
Yes
Yes
Fillable Printable
Form and Instruction
HUD 90105c
Model Lease 202 PRAC
HUD90105c_.doc
Yes
Yes
Fillable Fileable
Form and Instruction
HUD 90105d
Model Lease 811 PRAC
HUD90105d_.doc
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Homeownership Promotion
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
2,160,726
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
99 %
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
3,277,693
0
0
-1,686,912
0
4,964,605
Annual IC Time Burden (Hours)
1,348,679
0
-571,752
0
0
1,920,431
Annual IC Cost Burden (Dollars)
0
0
0
0
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.