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: 2577-0229	ICR Reference No: 202306-2577-001
Status: Active	Previous ICR Reference No: 202103-2577-003
Agency/Subagency: HUD/PIH	Agency Tracking No: 2577-0229
Title: Application for the Resident Opportunities and Self Sufficiency (ROSS) Program
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/30/2023
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/15/2023
Terms of Clearance: In any subsequent revisions or extensions to this form, the agency will upload as a supplemental document the full Notice of Funding Opportunity.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2026	36 Months From Approved	01/31/2024
Responses	350	0	350
Time Burden (Hours)	1,181	0	1,376
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	350	350	0
Annual Time Burden (Hours)	1,181	1,376	-195
Annual Cost Burden (Dollars)	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Changing Forms

Short Statement: The HUD-52768 form was revised to collect necessary information from applicants serving residents in RAD PBV or RAD PBRA units so that HUD may determine eligibility and award amounts

Annual Cost to Federal Government: $0

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

Agency Contact: Tremayne Youmans 202 402-6621 tremayne.e.youmans@hud.gov