Required Screens for the Physical Assessment Subsystem (PASS) Exigent Health & Safety (EH&S) Reporting Application

Exigent Health and Safety Deficiency Correction Certification

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2577-0241 can be found here:

Documents and Forms

Document Name Document Type
Exhibit of Templates 2016 11.29.16.docx Other-Template

Information Collection (IC) Details

IC Title:	Required Screens for the Physical Assessment Subsystem (PASS) Exigent Health & Safety (EH&S) Reporting Application	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 24 CFR part 5 subpart G 24 CFR 902 subpart B (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
Other-Template			Exhibit of Templates 2016 11.29.16.docx		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Homeownership Promotion

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,000	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	971	-163	1,134
Annual IC Time Burden (Hours)	273	-73	346
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.