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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 880
24 CFR Part 5
24 CFR 891 Subpart E
24 CFR 5.233
24 CFR 884
24 CFR 886
(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 and Instruction
HUD 90100
Annual Recertification
Final - HUD Form - 90100.docx
Yes
Yes
Fillable Fileable
Form and Instruction
HUD 90101
Certification for Qualified Long-Term Care Insurance Expenses
Final - HUD Form 90101.docx
Yes
Yes
Fillable Fileable
Form and Instruction
HUD 90104
Exception to Limitations on Admission of Families
Final - HUD Form 90104.docx
Yes
Yes
Fillable Fileable
Form and Instruction
HUD 90102
Sample Verification of Disability
Final - HUD Form 90102.docx
Yes
Yes
Fillable Fileable
Form and Instruction
HUD 50059
Owner's Certification of Compliance with HUD's Tenant Eligibility and Rent Procedures
Final - HUD Form 50059.docx
Yes
Yes
Fillable Fileable
Form and Instruction
HUD 50059 A
Owner's Certification of Compliance - Partial Certificaiton
Final - HUD Form 50059-A.docx
Yes
Yes
Fillable Fileable
Form and Instruction
HUD 90106
Appendix 5 - Sample Move-In/Move Out Inspection Form
Final - HUD Form 90106.docx
Yes
Yes
Fillable Fileable
Form and Instruction
HUD 90167
Lease Addendum
90167-ca.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
HUD 90166
Certificaiton of Domestic Violence, Dating Violence or Stalking
90066.pdf
Yes
No
Fillable Fileable
Form and Instruction
HUD 90105 a
Appendix 4-A Model Lease for Subsidized Programs
Final - HUD Form 90105-A.docx
Yes
Yes
Fillable Fileable
Form and Instruction
HUD 90105b
Appendix 4-B - Model Lease
Final - HUD Form 90105-B.docx
Yes
Yes
Fillable Fileable
Form and Instruction
HUD 90105 c
Appendix 4-C 202 PRAC Lease
Final - HUD Form 90105-C.docx
Yes
Yes
Fillable Fileable
Form and Instruction
HUD 90105d
Appendix 4-D 811 PRAC Lease
Final - HUD Form 90105-D.docx
Yes
Yes
Fillable Fileable
Form and Instruction
HUD 27061-h
Race and Ethnic Reporting Form
Final - HUD Form-27061-H.docx
Yes
Yes
Fillable Fileable
Form and Instruction
HUD9887
Document Package for Applicant's/Tenant's Consent to the R
Final - HUD Form 9887-9887-A.docx
Yes
Yes
Fillable Fileable
Form and Instruction
90011
Coordinator Access Authorization Form
Final - HUD Form 90011.docx
Yes
Yes
Fillable Fileable
Form and Instruction
90012
User Access Authorization Form
Final - HUD Form 90012.docx
Yes
Yes
Fillable Fileable
Instruction
Final - HUD Form 50059 Instructions.docx
Yes
Yes
Paper Only
Instruction
Final - EIV and You.docx
No
Paper Only
Instruction
Final - HUD Form 50059-A Instructions.docx
No
Paper Only
Form
Form 92236
HUD Form 92236
Final - HUD Form 92236.docx
Yes
Yes
Fillable Fileable
Instruction
Final - Section8FactSheet.docx
No
Paper Only
Instruction
Final - Section236FactSheet.docx
No
Paper Only
Instruction
Final - Section202.162-811FactSheet.docx
No
Paper Only
Instruction
Final - RRR.docx
No
Paper Only
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:
6,961,498
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
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
6,961,498
0
2,834,319
0
4,127,179
0
Annual IC Time Burden (Hours)
1,625,155
0
-33,316
0
1,658,471
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
PIA
TRACS Privacy Impact Assessment.pdf
03/18/2014
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.