Federal Labor Standards Questionnaire(s); Complaint Intake Form

Forms and Documents

Document Name	Status
Form HUD-4730 Federal Labor Standards Questionnaire Form and Instruction	Modified
Form HUD-4731 Federal Labor Standards Complaint Intake Form Form and Instruction	Modified
Form HUD-4730- Spanish Federal Labor Standards Questionnaire Spanish version Form and Instruction	Modified
30 Day FRN.pdf Supplementary Document	2023-12-11
Final - Supporting Statement A.docx Supporting Statement A	2023-12-04
FR-7068-N-02 (2501-0018) 60-day FRNotice 7.10.23Signed.docx Supplementary Document	2023-11-29

IC Document Collections

IC ID	Document Title	Status
26959	Federal Labor Standards Questionnaire Form and Instruction	Modified
224330	Federal Labor Standards Complaint Intake Form Form and Instruction	Modified
224329	Federal Labor Standards Questionnaire Spanish version Form and Instruction	Modified

ICR Details

OMB Control No: 2501-0018	ICR Reference No: 202311-2501-002
Status: Received in OIRA	Previous ICR Reference No: 202010-2501-002
Agency/Subagency: HUD/HUDSEC	Agency Tracking No:
Title: Federal Labor Standards Questionnaire(s); Complaint Intake Form
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 12/11/2023

	Requested	Previously Approved
Expiration Date	36 Months From Approved	01/31/2024
Responses	1,000	2,500
Time Burden (Hours)	500	1,250
Cost Burden (Dollars)	0	0

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Abstract: The information is used by HUD to fulfill its obligation to enforce Federal Labor stanards provisions, especially to act upon allegations of labor standards violations.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 51846	08/04/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 84825	12/06/2023
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

IC Title	Form No.	Form Name
Federal Labor Standards Complaint Intake Form	HUD-4731	Federal Labor standards Complaint Intake Form
Federal Labor Standards Questionnaire	HUD-4730	Federal Labor Standards Questionnaire
Federal Labor Standards Questionnaire Spanish version	HUD-4730- Spanish version	Federal Labor Standards Questionnaire Spansh Version

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ICR Summary of Burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	1,000	2,500	0	-1,500	0	0
Annual Time Burden (Hours)	500	1,250	0	-750	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: This is a revision of a currently approved collection. The annual number of respondents was changed from the previously reported 2,500 individuals to 1,000 individuals. This is a result of the number individuals completing the forms and filing a complaint has decreased in the last several years and 1,000 more accurately reflects what is actually received in the field. The time burden hourly estimate remains the same at .50 hours. The annual time burden decreased from 1,250 hours to 500 hours because the estimated number of respondents decreased.

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Annual Cost to Federal Government: $47,200

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 12/11/2023

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