Recipient Payment Information Form

Emergency Rental Assistance Program (ERA1)

Documents and Forms

Document Name Document Type
Recipient Payment Information Form Form and Instruction
Recipient Payment Information Form Form and Instruction
Emergency Recipient Payment Information Form ERA Recipient Payment Information Form (Final 1-04-2021).docx Form and Instruction
Emergency Recipient Payment Information Form ERA Recipient Payment Information Form (Final 1-04-2021).docx Form and Instruction

Information Collection (IC) Details

IC Title:	Recipient Payment Information Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	n/a	Emergency Recipient Payment Information Form	ERA Recipient Payment Information Form (Final 1-04-2021).docx		Yes	Yes	Fillable Fileable

Line of Business: Disaster Management

Subfunction: Disaster Repair and Restore

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,150	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1,150	1,150
Annual IC Time Burden (Hours)	288	288
Annual IC Cost Burden (Dollars)	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.