Pay for Success Permanent Supportive Housing Demonstration (PFS) Demonstration

Forms and Documents

Document Name	Status
Form HUD 2880 Pay for Success Permanent Supportive Housing Demonstration Form	New
Supporting Statement explanation - PFS June 15.doc Supporting Statement A	2015-06-25
Emergency letter with Harriet on it.pdf Supplementary Document	2015-06-18

IC Document Collections

IC ID	Document Title	Status
217148	Pay for Success Permanent Supportive Housing Demonstration Form	New

ICR Details

OMB Control No: 2506-0207	ICR Reference No: 201506-2506-002
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HUD/CPD	Agency Tracking No:
Title: Pay for Success Permanent Supportive Housing Demonstration (PFS) Demonstration
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 07/01/2015
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/26/2015
	Date Received in OIRA: 06/25/2015
Terms of Clearance: This collection is granted emergency approval for 6 months. HUD must resubmit the package prior to its expiration in 6 months and allow ample time for public comment to be received and processed. HUD should also reassess the burden for the package during the re-submission process by consulting with 9 or fewer respondents who completed the application process and update the burden estimates at that time.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2015	6 Months From Approved
Responses	9	0	0
Time Burden (Hours)	195	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The PFS Demonstration NOFA requires private and public nonprofit applicants to respond to selection criteria by demonstrating their experience and expertise in PFS financing and by describing the intended program design. The full application consists of narrative answers and a list of required attachments. A work plan will be development jointly with HUD for each grantee, and will serve as the benchmark for ongoing recordkeeping and reporting

Emergency Justfication: The emergency processing is requested to ensure that this innovative PFS Demonstration can proceed on expedited schedule. The information gathered through he application is essential for the Department to fairly and expeditiously review and score applicants based on their experience, expertise, and proposed PFS activities

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 36352	06/24/2015
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Pay for Success Permanent Supportive Housing Demonstration	HUD 2993, HUD 2880, HUD 96011	Applicant/Recipient/Disclosure/Update Report ,   Acknowledgment of Application Receipt ,   Third Party Documentation

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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	9	0	0	9	0	0
Annual Time Burden (Hours)	195	0	0	195	0	0
Annual Cost Burden (Dollars)	0	0	0	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: No

Burden Reduction Due to:

Short Statement: new collection

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Annual Cost to Federal Government: $1,697

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? 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? Uncollected

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Common Form ICR:  No

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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: 06/25/2015

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