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:
Application for the Community Development Block Grant Program for Indian Tribes and Alaska Native Villages (ICDBG)
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 1003
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
HUD 4123
Cost Summary
4123.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
HUD 4125
Implementation Schedule
4125.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
SF 424
Application for Federal Assistance
sf424.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
HUD 2880
Applicant/Receipt Disclosure/Update Report
2880.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
HUD 2993
Acknowledgment of Application Receipt
2993.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
SF 424 Supp
Survey on Ensuring Equal Opportunity for Applicants
sf424sup.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
HUD 96010
Logic Model ICDBG
ICDBG XL.xls
Yes
Yes
Fillable Fileable
Form and Instruction
SF 269
Financial Status Reports
sf269.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
SF 272
Federl Cash Transaction Report
sf272.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
HUD*2994-A
Grant Applicant Survey
2994-A.doc
Yes
Yes
Fillable Printable
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:
225
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
99 %
Requested
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
1,140
0
15
-100
0
1,225
Annual IC Time Burden (Hours)
9,370
0
45
0
0
9,325
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.