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
This script is used to control the display of information in this page.
Display additional information by clicking on the following:
All
Brief and OIRA conclusion
Abstract/Justification
Legal Statutes
Rulemaking
FR Notices/Comments
IC List
Burden
Misc.
Common Form Info.
Certification
View Information Collection (IC) List
View Supporting Statement and Other Documents
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
2506-0020
ICR Reference No:
199105-2506-002
Status:
Historical Active
Previous ICR Reference No:
198904-2506-009
Agency/Subagency:
HUD/CPD
Agency Tracking No:
Title:
COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) PROGRAM - HUD ADMINISTERED SMALL CITIES PROGRAM - APPLICATION FOR CDBG FUNDS AND PERFORMANCE ASSESSMENT REPORT
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:
07/31/1991
Retrieve Notice of Action (NOA)
Date Received in OIRA:
05/21/1991
Terms of Clearance:
Approved by OMB under the following conditions: 1) HUD shall place the expiration date on HUD Form 4124.1 in accordanc with 5 CFR 1320.4 (a) in the next printing of the form. This expiration date shall be printed on each part of HUD Form 4124, including the Instructions, Part I- V and the Performance Assessment Report. 2) HUD shall print the required burden statement of 8 hours of the Performance Assessment Report, pursuant to 5 CFR 1320.4, in the next printing of the form. 3) HUD shall include an explanation of the recordkeeping requirements in the supporting statement. OMB has added therecordkeeping burden to this current terms of clearance consistent with the SF83. 3) In its next submission, HUD should provide greater detail on the actual number of jurisdictions that must respond to HUD Form 4124. 4) HUD shall not require applicants to resubmit information that is required by the Comprehensive Housing Affordability Strategy, if the applicant to the CDBG Small Cities Program is completing a CHAS for FY92. In its instructions to HUD Form 4052 HUD shall specify these information collections that may be duplicated by the CHAS (i.e. Part VI Maps (b)- location of area with minorities). If there is any duplication with the information collection requirements in the CHAS, HUD shall not require duplication in this program.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
06/30/1993
06/30/1993
Responses
570
0
0
Time Burden (Hours)
12,300
0
0
Cost Burden (Dollars)
0
0
0
Abstract:
TWO STATES, NEW YORK AND HAWAII, HAVE NOT ELECTED TO ASSUME ADMINISTRATIVE RESPONSIBILITY FOR THE NON-ENTITLED CDBG PROGRAM. HUD IS STATUTORILY MANDATED TO ADMINISTER THE PROGRAM IN THESE STATES. HUD FORM 4124 SERVES AS THE APPLICATION FOR CDBG FUNDS FOR NON-ENTITLE UNITS OF GENERAL LOCAL GOVERNMENT IN THESE STATES AND HUD FORM 4052 COLLECTS INFORMATION ON THE FINANCIAL AND PHYSICAL DEVELOPMENT STATUS
Authorizing Statute(s):
None
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Federal Register Notices & Comments
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) PROGRAM - HUD ADMINISTERED SMALL CITIES PROGRAM - APPLICATION FOR CDBG FUNDS AND PERFORMANCE ASSESSMENT REPORT
HUD-4124, HUD-4052
ICR Summary 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
570
0
0
0
570
0
Annual Time Burden (Hours)
12,300
0
0
0
12,300
0
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:
No
Burden Reduction Due to:
Short Statement:
Annual Cost to Federal Government:
$0
Does this IC contain surveys, censuses, or employ statistical methods?
No
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
Uncollected
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
Uncollected
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
Uncollected
Is this ICR related to the Pandemic Response?
Uncollected
Common Form ICR:
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:
(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:
05/21/1991