View Information Collection Request (ICR) Package
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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:
2577-0178
ICR Reference No:
202508-2577-002
Status:
Active
Previous ICR Reference No:
202009-2577-001
Agency/Subagency:
HUD/PIH
Agency Tracking No:
2577-0178
Title:
Family Self-Sufficiency Program (FSS)
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:
01/28/2026
Retrieve Notice of Action (NOA)
Date Received in OIRA:
09/03/2025
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
01/31/2029
36 Months From Approved
Responses
28,810
0
0
Time Burden (Hours)
39,520
0
0
Cost Burden (Dollars)
0
0
0
Abstract:
Housing agencies enter into a Contract of Participation with each eligible family that opts to participate in the program; consult with local officials to develop an Action Plan; and report annually to HUD on implementation of the FSS program. PHAs may apply for funding to pay the salary (including fringe benefits) of FSS program coordinators.
Authorizing Statute(s):
PL:
Pub.L. 101 - 625 23(c)
Name of Law: National Affordable Housing Act
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
90 FR 25070
06/13/2025
30-day Notice:
Federal Register Citation:
Citation Date:
90 FR 42422
09/02/2025
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
Family Self-Sufficiency Program (FSS)
HUD-52650, HUD-52651, HUD-2880, 424B, SF-424, SF-425, SFLLL, 52651-B, 52651-C, 50058 Family Report, 50058 MTW Expansion, 50058 Family Report
Family Self-Sufficiency (FSS) Program Contract of Participation - Housing Choice Voucher Public and Indian Housing Programs
,
Applicant/Recipient Disclosure/Update Report
,
Family Self-Sufficiency (FSS) Program Coordinator Funding
,
Applicant and Recipient Assurances and Certifications
,
Application for Federal Assistance
,
Federal Financial Report
,
Disclosure of Lobbying Activities
,
FSS Monitoring Review Tool
,
FSS Annual Survey
,
Family Report HCV-Sec Moderate Rehabiliation Program
,
MTW Expaansion Family Report PH-HCV
,
MTW Family Report
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
28,810
0
0
28,070
0
740
Annual Time Burden (Hours)
39,520
0
0
-27,730
0
67,250
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:
Yes
Burden Reduction Due to:
Changing Forms
Short Statement:
Reinstatement with changes of previously approved collection for which approval has expired The numbers are based on the following assumptions. The numbers have increased due to increased funding. The requirements have not changed. • Annual Applications/Grantees – 1000 o PIH Applications/Grantees – 800 o MF Applications/Grantees – 200 • Future new grantees – 200 • New Cooperative Agreements each year 250 • New participants each year 25,000 • Total participants each year 100,000 o PIH participants 80,000 o MF participants 20,000 • All applicants submit an SF-424, HUD-424B, HUD-52651 and a HUD-2880. They submit an SF-LLL if applicable. We may have a narrative for all applicants in the future. • All new grantees submit an FSS Action Plan • Every new participant requires a HUD-52650 Contract of Participation • Every PIH participant is reported on the HUD-50058 (or HUD-50058-MTW or HUD-50058-MTW Expansion). Since there is no FSS Addendum on the HUD-50059, we don’t use it. Instead, PBRA owners submit one PBRA FSS Reporting Tool (HUD-52653) each year. • Every FSS program will complete an Annual Survey once per year. • PIH will conduct a monitoring review of each program once every five years.
Annual Cost to Federal Government:
$88,886
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:
Anice Chenault 502 618-8163
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:
09/03/2025
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