HUD-50080 CFP LOCCS/eLOCCS Comprehensive Grant

LOCCS /eLOCCS
Comprehensive Grant

U.S. Department of Housing
and Urban Development
Office of Public and Indian Housing

OMB Approval No. 2577-0166 (exp. 08/31/2017)

Public reporting burden for this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing
data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. This agency may not collect this information, and
you are not required to complete this form, unless it displays a currently valid OMB control number.
HUD implemented the Line of Credit Control System/Voice Response System (LOCCS/ eLOCC to process requests for payments to grantees. The Line of Credit Control
Sy
This information is
The grantee will be prompted for entering the inform
required to obtain benefits under the U.S. Housing Act of l937, as amended. The information requested does not lend itself to confidentiality.
1. Voucher Number

2. LOCCS Pgrm. Area

3. Period Covered by this Request (mm/yyyy)

CFP

028

from:

to:

4.

1 = Partial Disbursement
2 = Final Disbursement

5. Voice Response No. (5 digits, hyphen, 5 more )

6. Grantee Organization's Name

7. Payee Organization's Name

8. Grant or Project No.

6a. Grantee Organization's TIN

7a. Payee Organization's TIN

9. Line Item No.

1406

Type of Funds Requested

* (cents)

Operations

1408

Management Improvements

1410

Administration

1411

Audit Costs (CGP)

1430

Fees & Costs

1440

Site Acquisition

1450

Site Improvement

1460

Dwelling Structures

1465

Amount (dollars)

Dwelling Equipment - Non-Expendable

1470

Non-Dwelling Structures

1475

Non-Dwelling Equipment

1485

Demolition

1492

Moving to Work Demonstration

1495

Relocation Costs

1499

Develop Activity

1501

PHA Paid debt service

$
10. Voucher Total
I certify the data reported and funds requested on this voucher are correct and the amount requested is not in excess of immediate disbursement needs for
this program. In the event the funds provided become more than necessary, such excess will be promptly returned, as directed by HUD.
11. Name & Phone Number (including area code)
of the Person who Completed this form

12. Name & Title of Authorized Signatory (type or print clearly)

13. Signature

14. Date of Request

X
Warning: HUD will prosecute false claims and statements. Conviction may result in criminal and/or civil penalties. (18 U.S.C. 1001, 1010, 1012; 31 U.S.C. 3729, 3802)
Privacy Statement: This statement is provided pursuant to the Privacy Act of 1974, 5 USC § 552a. The authority for collecting personally identifiable
information (PII) in the Regulatory Consistency Communication Board (RCCB) Electronic Feedback Form is based in Section 313 of Public Law 112-95.
The purpose of the data is to safeguard the Line of Credit Control System (LOCCS) from unauthorized access. The data are used to ensure that individuals who no longer
require access to LOCCS have their access capability promptly deleted. Failure to provide the information requested on the form may delay the processing of your
approval for access to LOCCS.

Previous edition is obsolete

form HUD-50080-CFP (4/2000)