Third-Party Documentation Facsimile Transmittal Form

ICR 201306-2535-002

OMB: 2535-0118

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Unchanged
Supporting Statement A
2008-03-11
IC Document Collections
ICR Details
2535-0118 201306-2535-002
Historical Active 200803-2535-001
HUD/OA
Third-Party Documentation Facsimile Transmittal Form
Reinstatement without change of a previously approved collection   No
Regular
Approved without change 11/13/2013
Retrieve Notice of Action (NOA) 09/17/2013
  Inventory as of this Action Requested Previously Approved
11/30/2016 36 Months From Approved
33,000 0 0
3,300 0 0
0 0 0

Facsimile transmittal information is necessary for submission of third-party documentation as part of an application for funding competitions.

None
None

Not associated with rulemaking

  78 FR 25290 04/30/2013
78 FR 49280 08/13/2013
No

1
IC Title Form No. Form Name
Third-Party Documentation Facsimile Transmittal Form HUD-96011 Third-Party Documentation Facsimile Transmittal

  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 33,000 0 0 0 0 33,000
Annual Time Burden (Hours) 3,300 0 0 0 0 3,300
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$37,950
No
No
No
No
No
Uncollected
Dorthera Yorkshire 202 402-4336 dorthera.yorkshire@hud.gov

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
09/17/2013


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