Family Self-Sufficiency Program (FSS)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2577-0178 can be found here:

Documents and Forms

Document Name Document Type
Form HUD-52650 Family Self-Sufficiency Program (FSS) Form and Instruction
96011.doc Other-Facsimile Transmittal
2994-A.doc Other-Survey
2991.pdf Other-Certification
HUD-52650 Family Self-Sufficiency program Contract of Participatio 52650.pdf Form and Instruction
HUD-52651 Housing Choice V oucher (HCV) Family Self-Sufficiency (F 52651r10-24.doc Form and Instruction
HUD-52652 FSS Escrow Account Credit Worksheet 52652.pdf Form and Instruction
SF 424 Application for Federal Assistance sf424.doc Form and Instruction
SF LLL Disclosure of Lobbying Activities sflllin.pdf Form and Instruction
HUD 2880 Applicant/Recipient Disclosure/Update Report 2880.doc Form and Instruction
HUD 50058 Family Report 50058.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Family Self-Sufficiency Program (FSS)	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 23(g) (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	HUD-52650	Family Self-Sufficiency program Contract of Participation	52650.pdf	Yes	Yes	Fillable Printable
Form and Instruction	HUD-52651	Housing Choice V oucher (HCV) Family Self-Sufficiency (FSS) Program Coordinator Funding	52651r10-24.doc	Yes	Yes	Fillable Fileable
Form and Instruction	HUD-52652	FSS Escrow Account Credit Worksheet	52652.pdf	Yes	Yes	Fillable Printable
Form and Instruction	SF 424	Application for Federal Assistance	sf424.doc	Yes	Yes	Fillable Fileable
Form and Instruction	SF LLL	Disclosure of Lobbying Activities	sflllin.pdf	Yes	Yes	Fillable Fileable
Other-Facsimile Transmittal			96011.doc	Yes	Yes	Fillable Fileable
Form and Instruction	HUD 2880	Applicant/Recipient Disclosure/Update Report	2880.doc	Yes	Yes	Fillable Fileable
Other-Survey			2994-A.doc	Yes	Yes	Fillable Fileable
Other-Certification			2991.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	HUD 50058	Family Report	50058.pdf	Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Homeownership Promotion

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 750	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	46,505	-95	46,600
Annual IC Time Burden (Hours)	36,202	-3,004	39,206
Annual IC Cost Burden (Dollars)	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.