Supporting Statement_2577-0286

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Implementation of the Violence Against Women Reauthorization Act of 2013

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Supporting Statement for Paperwork Reduction Act Submissions

OMB# 2577-0286

Implementation of the Violence Against Women Reauthorization Act of 2013

  1. Justification


  1. Explain the circumstances that make the collection of information necessary. Identify any legal or administrative requirements that necessitate the collection. Attach a copy of the appropriate section of each statute and regulation mandating or authorizing the collection of information.

The Violence Against Women Reauthorization Act of 2013 (VAWA 2013), Public Law 113-4, 127 Stat. 54, reauthorized and amended the Violence Against Women Act of 1994, as previously amended (title IV, sec. 40001-40703 of Public Law 103-322, 42 U.S.C. 13925 et seq.). In doing so, VAWA 2013 expanded the VAWA protections that applied to HUD’s Section 8 and Public Housing programs and widened the range of HUD’s housing programs that are subject to VAWA protections.


The provisions of VAWA 2013 that afford protections to victims of domestic violence, dating violence, sexual assault, or stalking are statutory and statutorily directed to be implemented. Accordingly, on November 16, 2016, HUD published a final rule at 81 FR 80724 (VAWA Rule), implementing VAWA 2013’s provisions in its housing programs.


VAWA was reauthorized by the Consolidated Appropriations Act, 2022, Public Law 117-103, on March 15, 2022. HUD is continuing to seek PRA approval of this information collection and related forms to implement the prior 2013 reauthorization, see Public Law 113-4, and will make the necessary adjustments to account for the 2022 reauthorization at a later time.


The HUD programs that include VAWA protections as required by VAWA 2013 and the VAWA Rule include:

  • Section 202 Supportive Housing for the Elderly (12 U.S.C. 1701q);

  • Section 811 Supportive Housing for Persons with Disabilities (42 U.S.C. 8013);

  • Housing Opportunities for Persons with AIDS (HOPWA) program (42 U.S.C. 12901 et seq);

  • HOME Investment Partnerships (HOME) program (42 U.S.C. 12741 et seq.);

  • Homeless programs under title IV of the McKinney-Vento Homeless Assistance Act (42 U.S.C. 11360 et seq.), including the Emergency Solutions Grants (ESG) program; the Continuum of Care (CoC) program; and the Rural Housing Stability Assistance program;

  • Multifamily rental housing under section 221(d)(3) of the National Housing Act (12 U.S.C. 17151(d)) with a below-market interest rate (BMIR) pursuant to section 221(d)(5);

  • Multifamily rental housing under section 236 of the National Housing Act (12 U.S.C. 1715z-1);

  • HUD programs assisted under the United States Housing Act of 1937 (42 U.S.C. 1437 et seq.); specifically, public housing under section 9 of the 1937 Act (42 U.S.C. 1437g), tenant-based and project-based rental assistance under section 8 of the 1937 Act (42 U.S.C. 1437f), and the Section 8 Moderate Rehabilitation Single Room Occupancy; and

  • The Housing Trust Fund (12 U.S.C. 4568).


To ensure covered housing providers (CHPs) under the programs listed above comply with VAWA 2013 and the VAWA Rule, the Department proposes to provide certain documents for use as follows:


  • Form HUD-5380: Notice of Occupancy Rights Under the Violence Against Women Act. HUD must provide this notice to CHPs, which must, in turn, distribute it to tenants and to applicants, at minimum, at the times specified in the VAWA Rule to ensure that tenants and applicants are aware of their rights under VAWA and its implementing regulations.


  • Form HUD-5381: Model Emergency Transfer Plan for Victims of Domestic Violence, Dating Violence, Sexual Assault, or Stalking. HUD must provide this model document to CHPs. CHPs must develop their own emergency transfer plans, as required by the VAWA Rule, must make their emergency transfer plan available upon request, and, when feasible, must make their plan publicly available. CHPs may, at their discretion, use HUD-5381 to develop these plans.


  • Form HUD-5382: Certification of Domestic Violence, Dating Violence, Sexual Assault, or Stalking, and Alternate Documentation. HUD must provide this certification form to CHPs, which must, in turn, distribute it to tenants and applicants as a required complement and extension of the required Notice of Occupancy Rights Under the Violence Against Women Act (Form HUD-5380). An individual may then submit and sign certifying that they are a victim of domestic violence, dating violence, sexual assault, or stalking and that the information provided on the form is true and correct to the best of their knowledge and recollection. The certification form serves as one tool for documenting the incident or incidents of domestic violence, dating violence, sexual assault, and stalking. (Note: This supersedes forms HUD-50066 and HUD-91066. VAWA 2013 required that the form be updated and made applicable to all covered housing programs.)


Applicants or tenants may provide third-party documentation along with or in lieu of form HUD-5382. The VAWA regulation stipulates that one such document –

  1. Be signed by an employee, agent, or volunteer of a victim service provider, an attorney, or medical professional, or a mental health professional (collectively, “professional”) from whom the victim has sought assistance relating to domestic violence, dating violence, sexual assault, or stalking, or the effects of the abuse or violence;

  2. Be signed by the applicant or tenant; and

  3. Specify, under penalty of perjury, that the professional believes in the occurrence of the incident of domestic violence, dating violence, sexual assault, or stalking that is the ground for VAWA protection and that the incident meets the applicable definition of domestic violence, dating violence, sexual assault, or stalking in 24 CFR 5.2003.


  • HUD-5383: Emergency Transfer Request for Certain Victims of Domestic Violence, Dating Violence, Sexual Assault, or Stalking. HUD provides this form to CHPs, which may, at their discretion, distribute it to tenants. This form serves as a model for use by a CHP to accept requests for emergency transfers under its required VAWA Emergency Transfer Plan.

  • Emergency Transfer Data Collection Form: HUD must provide the Emergency Transfer Data Collection Form to CHPs, and it is the responsibility of CHPs to complete and submit this form to HUD, for purposes of fulfilling recordkeeping and reporting requirements. CHPs must keep a record of all emergency transfers requested under its emergency transfer plan, the outcomes of such requests, and retain these records for a period of three years, or for a period as specified in program regulations. Requests and outcomes of emergency transfers must also be reported to HUD annually. See 24 C.F.R. 5.2005(e)(12). HUD may tailor this form to ask certain questions by selecting different areas of this form that are relevant to specific covered housing programs.


  • Lease Addendum: The VAWA regulation includes certain requirements that must be incorporated into tenants’ leases.



  1. Indicate how, by whom and for what purpose the information is to be used. Except for a new collection, indicate the actual use the agency has made of the information received from the current collection.

  • CHPs will use the Notice of Occupancy Rights (form HUD-5380) to inform individuals who may be covered under VAWA of their rights and protections.

  • CHPs may use the Model Emergency Transfer Plan (form HUD-5381) for their own planning purposes—to establish VAWA emergency transfer plans.

  • CHPs may use information gathered in the Self-Certification form (form HUD-5382) to determine whether individuals are entitled to protections under VAWA, after those individuals have used the form to document their status as a victim of domestic violence, dating violence, sexual assault, or stalking.

  • CHPs may use the information gathered on the Emergency Transfer Request form (form HUD-5383) to determine whether individuals are entitled to emergency transfers under VAWA, after those individuals have used the same document to request such an emergency transfer.

  • CHPs will also be required to complete the Emergency Transfer Data Collection Form (HUD-####) to report the number of VAWA emergency transfer requests and the outcomes of such requests. Only CHPs will be required to fill out certain parts of the Emergency Transfer Data Collection Form and will need to report outcomes of such requests to HUD annually and keep records for three years or as specified by program regulations and guidance.

  • CHPs will distribute lease addenda (or the equivalent) that contain the updated VAWA protections to their tenants.


  1. Describe whether, and to what extent, the collection of information involves the use of automated, electronic, mechanical, or other technological collection techniques or other forms of information technology, e.g., permitting electronic submission of responses, and the basis for the decision for adopting this means of collection. Also describe any consideration of using information technology to reduce burden.

With respect to the Notice of Occupancy Rights and the Certification form (forms HUD-5380 and HUD-5382), VAWA 2013 mandates that CHPs provide both of these documents to tenants and to applicants at the times specified in the VAWA Rule (for example, when an applicant is denied rental assistance). Providing such documents in paper form is consistent with leasing practice and ensures all individuals have unmediated access to the documents. Thus, it is logical to provide them in this way. With respect to the Model Emergency Transfer Plan (form HUD-5381), HUD provides the document as a tool for use by CHPs and its use is discretionary. Whether or not CHPs choose to use HUD’s model emergency transfer plan, CHPs must establish VAWA emergency transfer plans, as required by the VAWA Rule, and must ensure those plans contain the required elements outlined in 24 CFR 5.2005(e) and any applicable program regulations. CHPs must make their emergency transfer plan available upon request and may disseminate it via their website or any other means in which ensures access by their tenants or participants. With respect to the Emergency Transfer Request form (form HUD-5383), use of this document is also discretionary—thus, HUD is not requiring it to be distributed via a particular method.


HUD expects that CHPs will report emergency transfer data to HUD in an electronic format. The Department plans to include data elements in program-specific database programs that will allow CHPs to easily submit and HUD to easily obtain the data.

  1. HUD’s Public and Indian Housing Division will use:

DocuSign

Our VAWA emergency transfer data will be collected via DocuSign eSignature, specifically through the use of a DocuSign electronic self-service “PowerForm” template with fillable form fields. Participants in this data collection will click a hyperlink to launch this electronic form within a secure (https) web browser, manually enter questionnaire data into the form and submit the results via the secure connection.


Collected VAWA emergency transfer data can only be accessed and viewed in DocuSign by authorized internal HUD users. HUD user access to view collected VAWA emergency transfer data is granted exclusively by each departmental DocuSign Program Area Administrator (PAA). PAAs must be nominated by their Deputy Assistant Secretary (DAS) and complete DocuSign administration training in order to receive system administrator access.


DocuSign eSignature provides the following security measures to ensure privacy and data security for this process:


Physical security

  • Geo-dispersed data centers with active and redundant systems and physical and logically separated networks

  • Commercial-grade firewalls and border routers to detect IP-based and denial-of-service attacks

  • Malware protection

  • Secure, near real-time data replication

  • Around-the-clock onsite security

Platform security

  • Data encryption in transit and at rest with TLS connections and AES 256-bit encryption

  • Data access and transfer via HTTPS

  • Use of Security Assertion Markup Language (SAML), giving users the latest capabilities for Web-based authentication and authorization

  • PKI tamper-evident seal

  • Certificate of completion

  • Signature verification and unalterable capture of signing actions and completion status

  • Multiple authentication options for signers

Security certifications/processes


SharePoint

DocuSign is the system that will “collect” the VAWA data, but the data will be stored in a HUD-owned internal SharePoint site/list, to be created after finalization of the electronic data collection form.  A dynamic Microsoft Power Automate workflow will be configured to extract the submitted data in real time from DocuSign and populate the responses in the dedicated SharePoint list.  Access to both the SharePoint site/list where the data will be stored will be granted by the internal HUD site owner to specific HUD users with the business need to view this data.    


  1. HUD’s Housing Division: Multifamily Housing

MFH intends to update their monthly voucher to collect transfer data. For NI Section 236 IRP projects, we will develop a form to collect the data annually. Here’s a link to the form (“voucher”) that owners who have entered into rental assistance contracts with HUD submit monthly: https://www.hud.gov/sites/documents/52670.PDF. What we envision is adding fields such as:

1. Number of emergency transfer requests initiated (during the month);

2. Number of emergency transfer requests open since previous voucher;

3. Number of emergency transfer requests closed during the month and, for these, length of time since each closed request was initiated.


All of this information can be anonymized, with owners retaining specifics in their own files.

We will need to update the instructions as well: https://www.hud.gov/sites/documents/52670ins.doc


  1. HUD’s Community Planning and Development Home Investment Partnerships Program (HOME)/Housing Trust Fund (HTF) Division

The Office of Affordable Housing Preservation (OAHP) intends to collect VAWA data through the Consolidated Annual Performance and Evaluation Report (CAPER). 


The CAPER process is already familiar to HOME participating jurisdictions and HTF grantees to report on accomplishments and progress toward Consolidated Plan goals. Logistics would need to be worked out with the current Integrated Disbursement and Information System (IDIS) / programming, but it is possible that VAWA forms could be attached to the CAPER in IDIS. 


IV. HUD’s Community Planning and Development Division Housing Opportunities for Persons With AIDS (HOPWA)/Emergency Solutions Grant/Continuum of Care


HOPWA formula grantees and ESG recipients will report VAWA data through the Consolidated Annual Performance and Evaluation Report (CAPER). HOPWA competitive grantees and CoC recipients will report VAWA data through the Annual Performance Report (APR) or the equivalent annual reporting form.



In most cases, CHPs will distribute lease addenda (or the equivalent) in paper, consistent with program-specific leasing policies. Typically, tenants must sign leasing documents and these processes are currently done in person and with paper documents.


  1. Describe efforts to identify duplication. Show specifically why any similar information already available cannot be used or modified for use for the purposes described in Item 2 above.

Similar notices, model plans, and certification/request forms related to these purposes are not already available for the covered housing programs included in the regulation.


  1. If the collection of information impacts small businesses or other small entities (Item 5 of OMB Form 83 I) describe any methods used to minimize burden.



This rule implements the protections of VAWA 2013 in all HUD-covered housing programs. These protections are statutory and statutorily directed to be implemented. The statute does not exempt CHPs that may qualify as small entities from providing such protections to its applicants or tenants or provide fewer protections than covered entities that are larger entities. However, with respect to processes that may be found to be burdensome to small covered housing providers—such as the emergency transfer plan— HUD provides an emergency transfer plan for entities to use as a template in creating their own plan.

Regarding the emergency transfer data, HUD is disclosing a public reporting burden that the collection of information is estimated to take 30-minutes to one hour per response depending on the program including collecting, reviewing and reporting information.


  1. Describe the consequence to Federal program or policy activities if the collection is not conducted or is conducted less frequently, as well as any technical or legal obstacles to reducing burden.

The protections afforded under VAWA 2013 are statutory and statutorily directed to be implemented by HUD. Thus, HUD is statutorily required to provide relevant resources and information to be provided, collected, and distributed. In its final VAWA Rule, HUD not only articulated the burdens to be imposed upon CHPs, but also aimed to alleviate those burdens by providing forms, some of which, can be adopted by the CHPs for additional specificity. HUD has also developed an additional form for Emergency Transfer Data Collection that CHPs will be required to complete and submit to HUD annually or as specified by program regulations and guidance. HUD will be providing technical assistance (TA) around VAWA implementation and compliance including TA as related to completing said forms when published. HUD will be translating the documents into multiple languages.


  1. Explain any special circumstances that would cause an information collection to be conducted in a manner:

  • Requiring respondents to report information to the agency more than quarterly;

        • As mentioned above, the Office of Multifamily Housing (MFH) intends to update their monthly voucher to collect VAWA emergency transfer data from owners on a monthly basis.

  • Requiring respondents to prepare a written response to a collection of information in fewer than 30 days after receipt of it;

        • Form (HUD-5382) only: As statutorily mandated by VAWA 2013, at the request of the CHP or the option of the covered individual, a covered individual must provide a completed certification form (or alternate documentation as appropriate) within 14 business days (or any extension of that date provided by the CHP) after receiving a written request for documentation from the CHP. Without some certification (or alternate documentation as appropriate), a CHP may determine that the individual is not covered by VAWA 2013 and thus is not entitled to its protections.

  • Requiring respondents to submit more than an original and two copies of any document; Not Applicable

  • Requiring respondents to retain records other than health, medical, government contract, grant-in-aid, or tax records for more than three years; Not Applicable

  • In connection with a statistical survey, that is not designed to produce valid and reliable results than can be generalized to the universe of study; Not Applicable

  • Requiring the use of a statistical data classification that has not been reviewed and approved by OMB; Not Applicable

  • That includes a pledge of confidentiality that is not supported by authority established in statute or regulation, that is not supported by disclosure and data security policies that are consistent with the pledge, or which unnecessarily impedes sharing of data with other agencies for compatible confidential use; or Not Applicable

  • Requiring respondents to submit proprietary trade secret, or other confidential information unless the agency can demonstrate that it has instituted procedures to protect the information's confidentiality to the extent permitted by law. Not Applicable


  1. If applicable, provide a copy and identify the date and page number of publication in the Federal Register of the agency's notice, required by 5 CFR 1320.8(d), soliciting comments on the information collection prior to submission to OMB. Summarize public comments received in response to that notice and describe actions taken by the agency in response to these comments. Specifically address comments received on cost and hour burden.

Describe efforts to consult with persons outside the agency to obtain their views on the availability of data, frequency of collection, the clarity of instructions and recordkeeping disclosure, or reporting format (if any) and the data elements to be recorded, disclosed, or reported.

Consultation with representatives of those from whom information is to be obtained or those who must compile records should occur at least once every 3 years -- even if the collection of information activity is the same as in prior periods. There may be circumstances that preclude consultation in a specific situation. These circumstances should be explained.

For Form HUD-5380, Form HUD-5381, Form HUD-5382, Form HUD-5383, and VAWA Emergency Transfer Data Collection Form, HUD published a Notice of Proposed Information Collection for Public Comments in the Federal Register, 87 FR 66723, dated November 4, 2022. The public was given until January 3, 2023 to submit comments on the proposed information collection. There was a total of 10 public comments received.

HUD also hosted two consultation sessions concerning VAWA implementation. HUD held the first consultation with survivor advocates and victim service providers on June 22, 2023, in which participants from 61 organizations participated in the online session. HUD held the second consultation on June 23, 2023, with housing providers and trade associations in which participants from 49 different organizations participated.

Comments for which HUD asked specific questions or made changes in response to are addressed in HUD’s 30-day Notice of Proposed Information Collection for Public Comments in the Federal Register. All other comments are discussed here:


HUD-5380: Notice of Occupancy Rights

Comments: Commenters noted issues related to readability, accessibility, and content redundancy in Form HUD-5380. Commenters highlighted that the Form was too crowded, the font size was too small, and there was content duplicative of what was in Form HUD-5382. Some commenters suggested that the Form include plain language, use charts for easier reference, and contain clear links and resources. Commenters also recommended that the Form specify the process for documenting and addressing VAWA violence and trauma, streamline the confidentiality language, and revise the lease bifurcation provisions.

HUD Response: HUD is committed to enhancing the Form’s accessibility and readability. HUD has refined the language regarding documentation requirements and lease bifurcation, clarified survivors' VAWA rights, and added specific links to resources where possible. HUD also has clarified essential language regarding survivor confidentiality. Further, HUD has retained references to Form HUD-5380 in other VAWA forms to help ensure that survivors are informed of their VAWA rights.


HUD-5381: Model Emergency Transfer Plan

Comments: Commenters suggested various improvements to Form HUD-5381 to increase its utility for compliance purposes for housing providers. Key issues included the need for clearer language regarding the requirements for emergency transfers and ensuring the emergency transfer plan is readily accessible and understandable. Commenters recommended that HUD provide a standardized model plan that can be easily adapted by different housing programs, to reduce the need for each provider to "reinvent the wheel." Furthermore, concerns were raised about the estimated time required to adapt the model plan, with suggestions that more realistic estimates should be considered.

HUD Response: HUD believes that the current template offers the necessary flexibility for adaptation by covered housing providers. HUD also acknowledges the need for the emergency transfer plan to be publicly accessible and has included instructions for covered housing providers to provide information about their policy on how the plan will be made publicly available, when feasible. HUD has reviewed the burden estimate and does not think further revisions of the estimate are necessary.


HUD-5382: Self-Certification Form

Comments: Commenters highlighted that Form HUD-5382 lacked clarity about VAWA documentation requirements and methods of safe communication for survivors. Commenters noted that the language about documentation was confusing and recommended including a previously removed 14-business day window for documentation submission. Commenters also suggested the addition of sections that would allow survivors to specify safe methods of communication and provide additional context for their circumstances. Some commenters also raised issues about the Form's overall length and accessibility, emphasizing the need for clear, concise, and understandable content for people with low literacy and those with disabilities.

HUD Response: HUD agrees with the importance of accessibility and readability and has made efforts to simplify the Form via edits to the language, formatting, and organization. HUD has clarified the documentation language and restored the 14-business day window. Further, HUD has added a section for survivors to indicate their preferred methods of contact, to help ensure that communications are received safely and securely.


HUD-5383: Emergency Transfer Request Form

Comment: Commenters highlighted that former Question 8 could create unrealistic expectations about the availability of desired housing features in prospective units, potentially delaying the emergency transfer process. Furthermore, commenters said that the Form's language did not properly address covered housing providers' rights to request documentation and suggested revisions to more accurately reflect these requirements. Other recommendations included adding clearer instructions for safe communication with survivors, language about integrating interim safety planning measures as well as language about the ability for survivors to identify necessary temporary absences or specific safety features in their requested unit.

HUD Response: HUD has included clarifying language regarding covered housing providers' ability to request VAWA documentation and survivors’ eligibility to request emergency transfers. HUD also revised the Form so that survivors can specify safe communication methods and other safety preferences.


VAWA Emergency Transfer Data Collection Form

Comments: Commenters requested various data fields, including tracking the time between emergency transfer requests, approvals, and actual transfers. Some commenters asked for transparency in how quickly survivors were relocated to safe units.

HUD Response: HUD has included new data fields that capture the breakdowns of emergency transfer requests by timelines from request to rehousing. These changes aim to capture data that will help HUD, housing providers, and other stakeholders understand and address the emergency safe housing needs of survivors.


Language Access

Comments: Commenters requested that all VAWA forms be translated into the top 15 most spoken languages and that these forms include links to culturally specific victim services hotlines.

HUD Response: HUD anticipates translating the forms into multiple languages, consistent with its Language Access Plan (LAP). HUD has also revised the forms to emphasize language access requirements, including placing information about language access prominently and early on Form HUD-5380.


Administrative Burden

Comments: Commenters raised concerns about the underestimation of the time required to complete VAWA forms, suggesting that it typically takes longer than HUD's initial estimates. Additionally, commenters stated the need for more streamlined data collection methods that do not require new systems.

HUD Response: HUD has reviewed the burden estimate and does not think further revisions are necessary. Additionally, HUD is working on integrating VAWA data collection into existing electronic systems to reduce complexity and increase efficiency in data handling.


Safety Planning and Resources

Comments: Commenters noted the need for HUD’s VAWA forms to clearly indicate where survivors can find additional help and for housing providers to understand their roles in safety planning and referrals.

HUD Response: HUD has included a resource section in Form HUD-5380 and is developing VAWA training and technical assistance for housing providers to improve their capacity to support survivors effectively.


VAWA Training and Technical Assistance

Comments: Commenters highlighted a significant need for additional VAWA training and technical assistance, particularly for culturally specific organizations and smaller public housing agencies. Their emphasis was on building relationships with culturally specific providers and offering targeted training for housing providers in low-service areas.

HUD Response: HUD appreciates the commenters’ feedback and is working closely with VAWA Technical Assistance Providers to provide training and technical assistance that will address these training and technical assistance needs.


Lease Bifurcations and Family Break-Up

Comments: Commenters suggested that policies regarding lease bifurcations and family break-ups should be uniform and mandatory across all housing programs, emphasizing the need for consistent survivor support regardless of the program.

HUD Response: HUD will consider these suggestions as it engages in rulemaking to implement the most recent reauthorization of VAWA and for future VAWA guidance.


  1. Explain any decision to provide any payment or gift to respondents, other than remuneration of contractors or grantees.

No payment or gift will be made to respondents.



  1. Describe any assurance of confidentiality provided to respondents and the basis for assurance in statute, regulation or agency policy.

Confidentiality is a requirement in the VAWA statute. In drafting its final VAWA Rule, HUD considered confidentiality and included regulations specifically addressing it at 24 CFR §§ 5.2005(a)(1)(i), 5.2005(e)(4), 5.2007(c), and 574.604(b)(1)(i)(D), (b)(1)(ii)(A), (b)(2)(i)(D), and (b)(2)(ii)(A).

Information collected by HUD about providers or in aggregate about survivors will not be held confidential, although HUD typically only releases this type of information pursuant to the FOIA. HUD does not collect personally identifiable information about survivors in this information collection request and therefore, the Privacy Act does not apply. Survivor data collected by a provider shall, however, be held in strict confidence and HUD will work to enforce this through regulations and compliance therein.


  1. Provide additional justification for any questions of a sensitive nature, such as sexual behavior and attitudes, religious beliefs, and other matters that are commonly considered private. This justification should include the reasons why the agency considers the questions necessary, the specific uses to be made of the information, the explanation to be given to persons from whom the information is requested, and any steps to be taken to obtain their consent.

VAWA 2013 provides that, at the written request of a CHP, an individual may certify, via a HUD-approved self-certification form or certain alternative documentation, that the incident or incidents of VAWA violence/abuse are true and accurate for purposes of determining VAWA protection. The VAWA Rule also establishes a 14-business day deadline (plus any extensions granted by the CHP) from the date of such a written request, to complete and return the self-certification form. The Department therefore considers these forms and their contents necessary in order for victims of VAWA violence/abuse to receive the protections of VAWA. Recognizing that the forms of violence covered by VAWA are sensitive topics and that victims of such violence/abuse may be reluctant to provide information, the Department has tried to develop forms that clearly and concisely explain their purpose and what information is required. To that end, each form has a section that explains its purpose and another section that explains how to use the form, the timeline for submitting the form to the CHP, and a statement that the protections of VAWA may not apply if the form is not submitted in a timely manner. The form also informs the individual of alternate documentation that may satisfy the CHP’s written request for documentation as well as provides a confidentiality statement.


Additionally, the Emergency Transfer Data Collection form differs in a few ways from the forms mentioned above. Unlike the other HUD forms, the Data Collection form is required to only be filled out by providers, not survivors, and collects aggregated data. Additionally, the questions are related to VAWA emergency transfer requests and outcomes of these emergency transfers for reporting requirements, and further aim to refrain from questions sensitive in nature.


  1. Provide estimates of the hour burden of the collection of information. The statement should:

  • Indicate the number of respondents, frequency of response, annual hour burden, and an explanation of how the burden was estimated. Unless directed to do so, agencies should not conduct special surveys to obtain information on which to base hour burden estimates. Consultation with a sample (fewer than 10) of potential respondents is desirable. If the hour burden on respondents is expected to vary widely because of differences in activity, size, or complexity, show the range of estimated hour burden, and explain the reasons for the variance. Generally, estimates should not include burden hours for customary and usual business practices;

  • If this request covers more than one form, provide separate hour burden estimates for each form, and aggregate the hour burdens in Item 13 of OMB Form 83-I; and

  • Provide estimates of annualized cost to respondents for the hour burdens for collections of information, identifying and using appropriate wage rate categories. The cost of contracting out or paying outside parties for information collection activities should not be included here. Instead, this cost should be included in Item 13.

24 C.F.R. Section and Description of Activity

Number of Respondents

Frequency of Response (Annual, per respondent)

Annual Responses

Est. Avg. Time for Requirement (Hours)

Annual Hour Burden

Cost per Hour

Total Cost

5.2005(a) Form HUD-5380: Notice of Occupancy Rights and Form HUD-5382: Certification Form-Distribution and Review

Public Housing and Housing Choice Voucher (HCV)

Annual Average of Denied Admissions

3,918

7

27,426

0.08

2,194.08

$24

$52,657.92

Annual Average of new Households that Move In

3,918

55

215,490

0.08

17,239.20

$24

$413,740.80

Annual Average of Eviction Notices Sent

3,918

3

11,754

0.08

940.32

$24

$22,567.68

 

 

 

 

 

 

 

 

Multifamily Housing

Annual Average of Denied Admissions

23,000

15

345,000

0.08

27,600.00

$24

$662,400

Annual Average of new Households that Move In

23,000

9

207,000

0.08

16,560.00

$24

$397,440

Annual Average of Eviction Notices Sent

23,000

10

230,000

0.08

18,400.00

$24

$441,600

HOME

Annual Average of Denied Admissions

1,874

20

37,480

0.08

2,998.40

$24

$71,961.60

Annual Average of new Households that Move In

1,874

16

29,984

0.08

2,398.72

$24

$57,569.28

Annual Average of Eviction Notices Sent

1,874

8

14,992

0.08

1,199.36

$24

$28,784.64

HOPWA

Annual Average of Denied Admissions

255

20

5,100

0.08

408.00

$24

$9,792.00

Annual Average of new Households that Move In

255

20

5,100

0.08

408.00

$24

$9,792.00

Annual Average of Eviction Notices Sent

255

10

2,550

0.08

204.00

$24

$4,896.00

Homeless (CoC, ESG, and Rural Housing Stability)

Annual Average of Denied Admissions

6,350

5

31,750

0.08

2,540.00

$24

$60,960.00

Annual Average of new Households that Move In

6,350

1

6,350

0.08

508.00

$24

$12,192.00

Annual Average of Eviction Notices Sent

6,350

1

6,350

0.08

508.00

$24

$12,192.00

5.2005(e) Form HUD-5381: Emergency Transfer Plan-Completion

Public Housing and Housing Choice Voucher (HCV)

3,918

1x to establish with updates as needed

3,918

8

31,344.00

$24

$752,256.00

Multifamily Housing

23,000

1x to establish with updates as needed

23,000

8

184,000.00

$24

$4,416,000.00

HOME

11,874

1x to establish with updates as needed

1,874

8

14,992.00

$24

$359,808.00

HOPWA

255

1x to establish with updates as needed

255

8

2,040.00

$24

$48,960.00

Homeless (CoC, ESG, and Rural Housing Stability)

6,350

1x to establish with updates as needed

6,350

8

50,800.00

$24

$1,219,200.00


5.2007(b) Form HUD-5382: Certification Form--Documentation by Survivor



Public Housing and Housing Choice Voucher (HCV)

3,918

10

39,180

0.33

12,929.40

$7.25

$93,738.15


Multifamily Housing

23,000

6

138,000

0.33

45,540.00

$7.25

$330,165.00


HOME

1,874

15

28,110

0.33

9,276.30

$7.25

$67,253.18


HOPWA

255

5

1,275

0.33

420.75

$7.25

$3,050.44


Homeless (CoC, ESG, and Rural Housing Stability)

6,350

4

25,400

0.33

8,382.00

$7.25

$60,769.50




5.2005(e) Form HUD-5383: Emergency Transfer Request—Documentation by Survivor


Public Housing and Housing Choice Voucher (HCV)

3,918

5

19,590

0.33

6,464.70

$7.25

$46,869.08


Multifamily Housing

23,000

5

115,000

0.33

37,950.00

$7.25

$275,137.50


HOME

1,874

5

9,370

0.33

3,092.10

$7.25

$22,417.73


HOPWA

255

5

1,275

0.33

420.75

$7.25

$3,050.44


Homeless (CoC, ESG, and Rural Housing Stability)

6,350

5

31,750

0.33

10,477.50

$7.25

$75,961.88




5.2005(a) Lease Addendum—Distribution and Review


Public Housing and Housing Choice Voucher (HCV)

3,918

59

231,162

0.5

115,581.00

$24

$2,773,944.00


Multifamily Housing

23,000

24

552,000

0.5

276,000.00

$24

$6,624,000.00


HOME

1,874

18

33,732

0.5

16,866.00

$24

$404,784.00


HOPWA

255

50

12,750

0.5

6,375.00

$24

$153,000.00


Homeless (CoC, ESG, and Rural Housing Stability)

6,350

403

2,559,050

0.5

1,279,525.00

$24

$30,708,600.00




NEW: VAWA Emergency Transfer Data Collection Form


Public Housing and Housing Choice Voucher (HCV)

3,918

1

3,918

1

3,918

$24

$94,032.00


Multifamily Housing

23,000

1

23,000

.5

11,500

$24

$276,000.00

HOME

1,874

1

1,874

1

1,874

$24

$44,976.00


HOPWA

255

1

255

1

255

$24

$6,120.00


Homeless (CoC, ESG, and Rural Housing Stability)

6,350

1

6,350

1

6,350

$24

$152,400.00


Grand Total

293,176

Varies

5,044,764

Varies

2,230,480.58

 Varies

$51,270,938.82



Notes:

  • This matrix amends the one of the same title provided in the OMB Emergency PRA approval, 2577-0286, approved 12/13/2016, which provided for 3,622,370 hours.

  • For each category, HUD assumes the following breakdown of Covered Housing Provider respondents in covered housing programs: 3,918 public housing agencies that administer either or both public housing and HCV; 23,000 Multifamily Housing properties; 1,874 HOME Participating Jurisdictions (PJs) and housing owners; 255 HOPWA grant recipients, and 6,350 Homeless (CoC, ESG, and Rural Housing Stability ) grant recipients.


  • The “Frequency of Response (annual, per respondent)”, provides the estimated average of actions anticipated for each CHP in each program area. For example, HUD estimates that each Multifamily Housing property will deny assistance to 20 applicants each year. Therefore, the total number of responses and total number of Multifamily Housing assistance denials in one year is 23,000 x 20 = 460,000. Similarly, HUD estimates that each of the 255 HOPWA grant recipients will receive 5 completed Certification forms each year. The total number of responses and total number of certifications received in the HOPWA program in one year is 255 x 5 = 1,275.

  • The $24 hourly rate is based on an average salary of $50,000 per annum. An internet search on 11/5/2020 shows housing specialist positions with an average of $40,000 per annum and $55,000 per annum for residential property managers. This dollar amount is a reasonable average for employees of CHPs at differing levels of seniority.

  • $7.25 is used as the cost to tenants, as it is the federal minimum hourly wage amount.


  1. Provide an estimate of the total annual cost burden to respondents or record-keepers resulting from the collection of information (do not include the cost of any hour burden shown in Items 12 and 14).

  • The cost estimate should be split into two components: (a) a total capital and start-up cost component (annualized over its expected useful life); and (b) a total operation and maintenance purchase of services component. The estimates should take into account costs associated with generating, maintaining, and disclosing or providing the information. Include descriptions of methods used to estimate major cost factors including system and technology acquisition, expected useful life of capital equipment, the discount rate(s) and the time period over which costs will be incurred. Capital and start-up costs include, among other items, preparations for collecting information such as purchasing computers and software; monitoring, sampling, drilling and testing equipment; and record storage facilities;

  • If cost estimates are expected to vary widely, agencies should present ranges of cost burdens and explain the reasons for the variance. The cost of purchasing or contracting out information collection services should be a part of this cost burden estimate. In developing cost burden estimates, agencies may consult with a sample of respondents (fewer than 10) utilize the 60-day pre-OMB submission public comment process and use existing economic or regulatory impact analysis associated with the rulemaking containing the information collection, as appropriate.

    • Generally, estimates should not include purchases of equipment or services, or portions thereof made: (1) prior to October 1, 1995, (2) to achieve regulatory compliance with requirements not associated with the information collection, (3) for reasons other than to provide information or keep records for the government, or (4) as part of customary and usual business or private practices.

We do not estimate that there will be any additional costs to respondents or record-keepers beyond those identified in Item 12.


  1. Provide estimates of annualized cost to the Federal government. Also, provide a description of the method used to estimate cost, which should include quantification of hours, operational expenses (such as equipment, overhead, printing, and support staff), and any other expense that would not have been incurred without this collection of information. Agencies also may aggregate cost estimates from Items 12, 13, and 14 in a single table.

We do not estimate that there will be any additional costs to the Federal government for this information collection.



  1. Explain the reasons for any program changes or adjustments reported in Items 13 and 14 of the OMB Form 83-I.

HUD used a larger set of program specific data to calculate respondents, frequency of response, responses, burden hours, and costs in this package. The data used are a more accurate estimate of program operation. As a result, the following numbers have been reduced:

  • Number of respondents: from 1,103,365 to 293,176

  • Number of annual responses: from 19,777,290 to 5,044,764

  • Number of burden hours: from 3,622,370.00 to 2,230,480.58

  • Total cost: from $86,936,880.00 to $51,270,938.82.


  1. For collection of information whose results will be published, outline plans for tabulation and publication. Address any complex analytical techniques that will be used. Provide the time schedule for the entire project, including beginning and ending dates of the collection of information, completion of report, publication dates, and other actions.

There will be no publication of information collections.


  1. If seeking approval to not display the expiration date for OMB approval of the information collection, explain the reasons that display would be inappropriate.

HUD is not seeking approval to avoid displaying the OMB expiration date.


  1. Explain each exception to the certification statement identified in item 19.

There are no exceptions to the certification statement identified in item 19 of the OMB 83-I.


  1. Collections of Information Employing Statistical Methods


This collection of information will not be used for statistical purposes.

Signature of Senior Officer or Designee:



X

Colette Pollard, Departmental Reports Management Officer,

Office of the Chief Information Officer

Date:

OMB-83-I 10/95

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