Debts Owed To Public Housing Agencies and Terminations

Enterprise Income Verification (EIV) System - Debts owed to Public Housing Agencies and Terminations

Documents and Forms

Document Name Document Type
EIV System Screen Shots 2019.docx Other-EIV Screen Shots
EIV System Screen Shots 2019.docx Other-EIV Screen Shots
Form HUD 52675 DEBTS OWED TO PUBLIC HOUSING AGENCIES AND TERMINATIONS HUD-52675 form EIV System Debts Owned PRA XX.XX.XXXX.docx Form and Instruction
Form HUD 52675 DEBTS OWED TO PUBLIC HOUSING AGENCIES AND TERMINATIONS HUD-52675 form EIV System Debts Owned PRA XX.XX.XXXX.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Debts Owed To Public Housing Agencies and Terminations	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 24 CFR 5.233

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-EIV Screen Shots			EIV System Screen Shots 2019.docx		Yes	Yes	Printable Only
Form and Instruction	Form HUD 52675	DEBTS OWED TO PUBLIC HOUSING AGENCIES AND TERMINATIONS	HUD-52675 form EIV System Debts Owned PRA XX.XX.XXXX.docx		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,834	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	298,216	252,208	46,008
Annual IC Time Burden (Hours)	24,841	0	24,841
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.