Final - HUD 52698a EPGP Household Submission Report.xlsx

Eviction Protection Grant Program

Final - HUD 52698a EPGP Household Submission Report.xlsx

OMB: 2528-0331

Document [xlsx]
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Overview

Instructions
HUD 52698a
Data Dictionary
ReferenceLists


Sheet 1: Instructions

Public reporting burden for this collection of information is estimated to average one hour 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. You may send comments regarding this burden estimate or suggestions to reduce this burden to the Department of Housing and Urban Development (HUD) at PaperworkReductionActOffice@hud.gov. When providing comments, please refer to the Office of Management and Budget (OMB) Approval No. 2528-0331. Collection of this information is authorized by the Consolidated Appropriations Act, 2021 (Pub. L. No. 116-260, approved December 27, 2020), Consolidated Appropriations Act, 2022 (Pub. L. No. 117-103, approved March 15, 2022), Consolidated Appropriations Act, 2023 (Pub. L. No. 117–328, approved December 29, 2022), Consolidated Appropriations Act, 2024 (Pub. L. No. 118-42, approved March 9, 2024), and Section 502 of the Housing and Urban Development Act of 1970 (Pub. L. No. 91-609) (12 U.S.C. §§ 1701z-1; 1701z-2(d) and (g)). This information is being collected to assess program compliance and effectiveness. HUD intends to use this information for program compliance monitoring and research on program implementation, effectiveness, and impact, including grantee and tenant outcomes. This information is required to participate in the Eviction Protection Grant Program. HUD will not release any personally identifiable information pursuant to the Freedom of Information Act. This agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless that collection displays a valid OMB control number. 


HUD 52698a Instructions
Issue Discussion
Purpose The HUD 52698 data that grantees and subrecipeints collect for the Eviction Protection Grant Program (EPGP) must be reported to HUD in a consistent, standardized manner. Grantees and subrecipients must report HUD 52698 data on the HUD 52698a for submission to HUD, unless the grantee or subrecipient develops a submission report that is substanitally similar to HUD 52698a that is approved by your Government Technical Representative (GTR) for EPGP. If you are using your own case management system (CMS) to develop your HUD 52698a report, use this workbook is a guide in the development of internal reporting systems and reporting codes in order to standardize reporting across all service providers.
Contents The 52698a includes a sample tabulation of tenant data contained in the HUD 52698 and drop-downs for entering actual HUD 52698 data for each case closed during the quarter. The Data Dictionary is a guide to the field names and response options in the HUD 52698a derived from the HUD 52698.
Order of Precedence In the event of any inconsistency between the HUD 52698a, inclusive of these instructions and the Data Dictionary, and the HUD 52698, inclusive of instructions, the HUD 52698 shall take precedence.
Allowable Changes Add rows to HUD 52698a as needed. To add rows, right click the final row of the table and select "Insert Rows."

If you are using your own CMS to develop your HUD 52698a report, field names and response names may be changed to match existing business systems but must preserve the meanings defined in the Data Dictionary and HUD 52698. Gender Identity, Race and/or Ethnicity, Eviction-Related Fair Housing or Civil Rights Service, Alternative Dispute Resolution Service, and Outcomes allow multiple selections. There are alternative methods of indicating multiple-select: see Grouping Multiple-Select Items intruction below.

Note: Internal consistency over time is of absolute importance. Following development of a system that meets the requirements of this grant, please do not make changes without notifying your GTR.
Grouping Multiple-Select Items If you are using your own CMS to develop your HUD 52698a report, multiple-select items may be provided across independent columns as indicated in the HUD 52698a or grouped into a single column with a "," or ";" delimiter. For example, a tenant indicating they are White and Black or African American may be represented in a single "Race" column as "White; Black or African American." When using the multiple-column method, it is also acceptable to use the variable name in place of the attestation (e.g. "White" instead of "Yes" in the "R_White" column).

Note: Address elements from HUD 52698 item 5a may be grouped with other address address elements if delimited by ";" only. See Data Dictionary, HUD 52598a items 23–28.
Formulas Please ensure the final report submitted to HUD does not include any formulas. If any formulas are used in its creation, please copy and paste the entire report onto a new sheet and use the "Paste Values" option.
File Name Save the file for submission to HUD in the following format: 52698a-[GRANTEE]-Q[NUMBER]-MM-DD-YY, where [GRANTEE] is the grantee name, Q[NUMBER] is the sequential quarter of performance, and MM-DD-YY is the end date of the quarter. If a subrecipient's HUD 52698a report is not included in the grantee's HUD 52698a file, save the subrecipient's file for submission to HUD in the following format: 52698a-[SUBRECIPIENT]-Q[NUMBER]-MM-DD-YY, where [SUBRECIPIENT] is the subrecipient name, Q[NUMBER] is the sequential quarter of performance, and MM-DD-YY is the end date of the quarter.


Sheet 2: HUD 52698a

U.S. Department of Housing and Urban Development












OMB Control Number 2528-0331
























































Office of Policy Development and Research












Expires XX/XX/XXXX































































Eviction Protection Grant Program







































































Household Services and Outcomes Submission Report






































































HUD 52698a































































[Responsible Organization Name]






































































Quarterly Report:
[Quarter ending XX/XX/XXXX]




































































Quarter [X]














































































































































ID LEP G_Female G_Male G_Transgender G_NonBin G_NoResponse R_AmerInd_AKNative R_Asian R_Black Hispanic R_MENA R_Pacific R_White NumChild NumAdults Disability
TotIncome IncomeCat EvictionRisk StreetAdd Apt City State Zip4 County EvictParty EvictPHA RentSubsidized
RentSubsidized_O RentalAssist SameAddress Provider PriService FH_Advice FH_Representation ADR_Advocacy ADR_Settlement OtherService O_PreventEvictionFiling O_TenancyPreserved O_LeaseRenewed O_AdditionalDays NumAddDays O_EvictDelay O_RemedyLockout O_AlternateHouse O_DismissWithStips O_DismissNoStips O_RentReduce O_RentAssist O_OServiceBenefit O_ReduceDamages O_RepairImprove O_RestoreUtilities O_RecoverProperty O_RemedyDiscrimination O_ObtainAccommodation O_PreventRetaliation O_EnforcedORights O_DefaultEvict O_NotDefaultEvict O_Displacement O_AgreeSettle O_EvictSealed O_SatisfyJudgment O_Other O_Unknown AdditionalOutcomes TenantGoalsAcheived TenantGoalsAvheived_D CaseDuration
SAMPLE123 No Yes
Yes



Yes


Yes 1 1 Yes $42,300 Very Low Income At Risk of Eviction 123 Broad St Floor 3 Sample City MA 01234-1234 Worcester Sample Landlord Name LLC No Other Section 202 Supportive Housing for the Elderly Yes approved for or received assistance Yes Responsible Organization Name or Acronym Limited counsel and advice  No No No No Sample description of additional services Yes

Yes 30





Yes














Yes
Sample description of additional outcomes No Sample explanation (e.g., tenant wanted more time to move out) 15
















































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































The person entering data into this form, as well as the person submitting this form to HUD, certify under penalty of perjury that the information provided herein is true and correct. WARNING: Anyone who knowingly submits a false claim or makes a false statement is subject to criminal and/or civil penalties, including confinement for up to 5 years, fines, and civil and administrative penalties. (18 U.S.C. §§ 287, 1001, 1010, 1012, 1014; 31 U.S.C. §3729, 3802)
























































Sheet 3: Data Dictionary

HUD 52698a Data Dictionary












HUD 52698a Item # HUD 52698 Item # Field Name Field Full Name Item Grouping Item Description Response Type Field Response Description
1 1a ID Presenting Tenant Unique ID None The presenting tenant is the person seeking legal assistance. For HUD 52698 item 1a, the service provider named in HUD 52698 item 6 must assign a unique alphanumeric identifier no longer than 16 characters to the presenting tenant, unless the unique identifier was previously assigned by a known grantee, subrecipient, or contractor providing Eviction Protection Grant Program (EPGP) services to the presenting tenant. The presenting tenant unique identifier must be consistently used to report all EPGP matters closed so that non-contemporaneous EPGP matters closed with the same presenting tenant are measurable over the grant period of performance. Service providers may generate unique identifiers for the purposes of HUD 52698 reporting in a manner that protects client confidentiality. Alphanumeric Unique IDs should be limited to an alphanumeric identifier no longer than 16 characters. Service providers may generate unique identifiers for the purposes of HUD 52698a reporting in a manner that protects client confidentiality.
2 1b LEP Limited English Proficiency? None A presenting tenant who, as a result of his, her, or their national origin, does not speak English as a primary language and who has a limited ability to speak, read, write, or understand. Binary (Yes/No) Mark "yes" if the presenting tenant, as a result of his, her, or their national origin, does not speak English as a primary language and has a limited ability to speak, read, write, or understand. If the presenting tenant does not fit this description, mark "no".
3 1c G_Female Gender Identity: Female May be grouped with other gender identity items Select the category or categories that the presenting tenant says best indicates the presenting tenant’s gender identity. Select all that apply. Attestation (Yes/Blank) Mark "yes" if the presenting tenant self-identifies as female.
4 1c G_Male Gender Identity: Male May be grouped with other gender identity items Select the category or categories that the presenting tenant says best indicates the presenting tenant’s gender identity. Select all that apply. Attestation (Yes/Blank) Mark "yes" if the presenting tenant self-identifies as male.
5 1c G_Transgender Gender Identity: Transgender May be grouped with other gender identity items Select the category or categories that the presenting tenant says best indicates the presenting tenant’s gender identity. Select all that apply. Attestation (Yes/Blank) Mark "yes" if the presenting tenant self-identifies as transgender.
6 1c G_NonBin Gender Identity: Nonbinary/nonconforming May be grouped with other gender identity items Select the category or categories that the presenting tenant says best indicates the presenting tenant’s gender identity. Select all that apply. Attestation (Yes/Blank) Mark "yes" if the presenting tenant self-identifies as non-binary/non-conforming.
7 1c G_NoResponse Gender Identity: Prefer not to respond May be grouped with other gender identity items Select the category or categories that the presenting tenant says best indicates the presenting tenant’s gender identity. Select all that apply. Attestation (Yes/Blank) Mark "yes" if the presenting tenant prefers not to respond to this question.
8 1d R_AmerInd_AKNative Race and/or Ethnicity: American Indian or Alaska Native May be grouped with other race and/or ethnicity items Select the category or categories that the presenting tenant says best indicates the presenting tenant’s race and/or ethnicity. Select all that apply.
American Indian or Alaska Native means individuals with origins in any of the original peoples of North, Central, and South America, including, for example, Navajo Nation, Blackfeet Tribe of the Blackfeet Indian Reservation of Montana, Native Village of Barrow Inupiat Traditional Government, Nome Eskimo Community, Aztec, and Maya.
Attestation (Yes/Blank) Mark "yes" if the presenting tenant self-identifies as American Indian or Alaska Native.
9 1d R_Asian Race and/or Ethnicity: Asian May be grouped with other race and/or ethnicity items Select the category or categories that the presenting tenant says best indicates the presenting tenant’s race and/or ethnicity. Select all that apply.
Asian means individuals with origins in any of the original peoples of Central or East Asia, Southeast Asia, or South Asia, including, for example, Chinese, Asian Indian, Filipino, Vietnamese, Korean, and Japanese.
Attestation (Yes/Blank) Mark "yes" if the presenting tenant self-identifies as Asian.
10 1d R_Black Race and/or Ethnicity: Black or African American May be grouped with other race and/or ethnicity items Select the category or categories that the presenting tenant says best indicates the presenting tenant’s race and/or ethnicity. Select all that apply.
Black or African American means individuals with origins in any of the Black racial groups of Africa, including, for example, African American, Jamaican, Haitian, Nigerian, Ethiopian, and Somali.
Attestation (Yes/Blank) Mark "yes" if the presenting tenant self-identifies as Black or African American.
11 1d R_Hispanic Race and/or Ethnicity: Hispanic or Latino May be grouped with other race and/or ethnicity items Select the category or categories that the presenting tenant says best indicates the presenting tenant’s race and/or ethnicity. Select all that apply.
Hispanic or Latino includes individuals of Mexican, Puerto Rican, Salvadoran, Cuban, Dominican, Guatemalan, and other Central or South American or Spanish culture or origin.
Attestation (Yes/Blank) Mark "yes" if the presenting tenant self-identifies as Hispanic or Latino.
12 1d R_MENA Race and/or Ethnicity: Middle Eastern or North African May be grouped with other race and/or ethnicity items Select the category or categories that the presenting tenant says best indicates the presenting tenant’s race and/or ethnicity. Select all that apply.
Middle Eastern or North African means individuals with origins in any of the original peoples of the Middle East or North Africa, including, for example, Lebanese, Iranian, Egyptian, Syrian, Iraqi, and Israeli.
Attestation (Yes/Blank) Mark "yes" if the presenting tenant self-identifies as Middle Eastern or North African.
13 1d R_Pacific Race and/or Ethnicity: Native Hawaiian or Other Pacific Islander May be grouped with other race and/or ethnicity items Select the category or categories that the presenting tenant says best indicates the presenting tenant’s race and/or ethnicity. Select all that apply.
Native Hawaiian or Pacific Islander means individuals with origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands, including, for example, Native Hawaiian, Samoan, Chamorro, Tongan, Fijian, and Marshallese.
Attestation (Yes/Blank) Mark "yes" if the presenting tenant self-identifies as Native Hawaiian or Other Pacific Islander.
14 1d R_White Race and/or Ethnicity: White May be grouped with other race and/or ethnicity items Select the category or categories that the presenting tenant says best indicates the presenting tenant’s race and/or ethnicity. Select all that apply.
White means individuals with origins in any of the original peoples of Europe, including, for example, English, German, Irish, Italian, Polish, and Scottish.
Attestation (Yes/Blank) Mark "yes" if the presenting tenant self-identifies as White.
17 2a NumChild Total number of children living in household (under age 18) None A household includes all the people who occupy the rental housing unit at issue in the pending or potential eviction matter. For HUD 52698 item 2a, indicate the total number of persons under age 18 living in the household. Numeric Enter a whole number
18 2b NumAdults Total number of adults living in household (age 18 & older) None Indicate the total number of persons age 18 and older living in the household. Numeric Enter a whole number
19 2c Disability Household member has a disability None Indicate whether or not the presenting tenant or other member of their household has a disability. A person with disabilities has one or more of the following: (a) a disability as defined in Section 223 of the Social Security Act, (b) a physical, mental, or emotional impairment which is expected to be of long-continued and indefinite duration, substantially impedes his or her ability to live independently, and is of such a nature that such ability could be improved by more suitable housing conditions, (c) a developmental disability as defined in Section 102 of the Developmental Disabilities Assistance and Bill of Rights Act or (d) a disability as defined in 24 CFR § 8.3, for purposes of reasonable accommodation and program accessibility for persons with disabilities. Note: Include persons who have the acquired immune deficiency syndrome (AIDS) or any condition that arises from the etiologic agent for AIDS. Binary (Yes/No) Mark "yes" if the presenting tenant or other member of their household has a disability. If neither the presenting tenant nor other members of their household fit this description, mark "no".
20 3a TotIncome Total annual family income None Indicate the family’s total annual incomes. Numeric Enter a whole number
21 3b IncomeCat Family income group None Select one category that represents the family’s income relative to the local area median income based on the number of persons in the household. See HUD’s income limits website: https://www.huduser.gov/portal/datasets/il.html. Categorical Select the applicable category: Extremely Low Income, Very Low Income, or Low Income.
22 4 EvictionRisk Eviction Risk None Select one category that best reflects the presenting tenant’s circumstances at the time of initial engagement.
At risk of eviction and Subject to eviction have the meanings set forth in the HUD Eviction Protection Grant Program Notice of Funding Opportunity.
Categorical Select the applicable category: At risk of eviction or Subject to eviction
23 5a StreetAdd Rental Housing Unit Physical Address: Number and Street May be grouped with other address items IF delimited by ";" only. Indicate the physical address of the presenting tenant’s rental housing unit at issue in the pending or potential eviction matter. Indicate the city, state, full 9-digit ZIP Code, and county at a minimum. Other physical address details (building number, street, and unit number) are optional for reporting purposes. Free text Enter the building number and street (optional)
24 5a Apt Rental Housing Unit Physical Address: Apt May be grouped with other address items IF delimited by ";" only. Indicate the physical address of the presenting tenant’s rental housing unit at issue in the pending or potential eviction matter. Indicate the city, state, full 9-digit ZIP Code, and county at a minimum. Other physical address details (building number, street, and unit number) are optional for reporting purposes. Free text Enter the unit number (optional)
25 5a City Rental Housing Unit Physical Address: City May be grouped with other address items IF delimited by ";" only. Indicate the physical address of the presenting tenant’s rental housing unit at issue in the pending or potential eviction matter. Indicate the city, state, full 9-digit ZIP Code, and county at a minimum. Other physical address details (building number, street, and unit number) are optional for reporting purposes. Free text Enter the city name
26 5a State Rental Housing Unit Physical Address: State May be grouped with other address items IF delimited by ";" only. Indicate the physical address of the presenting tenant’s rental housing unit at issue in the pending or potential eviction matter. Indicate the city, state, full 9-digit ZIP Code, and county at a minimum. Other physical address details (building number, street, and unit number) are optional for reporting purposes. Free text Please enter as two-character state code
27 5a Zip4 Rental Housing Unit Physical Address: Zip + 4 Code May be grouped with other address items IF delimited by ";" only. Indicate the physical address of the presenting tenant’s rental housing unit at issue in the pending or potential eviction matter. Indicate the city, state, full 9-digit ZIP Code, and county at a minimum. Other physical address details (building number, street, and unit number) are optional for reporting purposes. Free text Enter as XXXXX-XXXX. For states whose zip codes begin with 0, it is especially important to use the right formatting. In Microsoft Excel it is sometimes necessary to change the formatting of the field to "Custom" and enter "00000-0000" in the "Type" field.
28 5a County Rental Housing Unit Physical Address: County May be grouped with other address items IF delimited by ";" only. Indicate the physical address of the presenting tenant’s rental housing unit at issue in the pending or potential eviction matter. Indicate the city, state, full 9-digit ZIP Code, and county at a minimum. Other physical address details (building number, street, and unit number) are optional for reporting purposes. Free text Enter the county name
29 5b EvictParty Evicting Party None Indicate the Evicting Party name in the pending or potential eviction matter with respect to the unit listed in HUD 52698 item 5a.
Evicting Party has the meaning set forth in the HUD Eviction Protection Grant Program Notice of Funding Opportunity.
Free text Enter Evicting Party name
30 5c EvictPHA Is the Evicting Party a public housing agency (PHA)? None Indicate whether the Evicting Party listed in HUD 52698 item 5b is a public housing authority or agency (PHA). Binary (Yes/No) Mark "yes" if the Evicting party is a PHA. If the Evicting Party is not a PHA, mark "no".
31 5d RentSubsidized Is the presenting tenant’s rent for the unit listed in HUD 52698 item 5a subsidized by a federal housing program? None Indicate whether the presenting tenant’s rent for the unit listed in HUD 52698 item 5a is subsidized by a federal housing program at the time of initial engagement. This information may be self-reported by the presenting tenant if documentation or third-party confirmation of a federal housing subsidy is not available. Do not include short-term emergency rental assistance in HUD 52698 item 5d. Categorical Select the applicable category: HUD Public Housing; HUD Housing Choice Voucher (Section 8); HUD Project-Based Section 8; Low Income Housing Tax Credit (LIHTC); USDA Rural Housing; Other; Yes, but unsure which program; or No.
32 5d RentSubsidized_O Other federal housing subsidies (briefly describe) None Indicate whether the presenting tenant’s rent for the unit listed in HUD 52698 item 5a is subsidized by a federal housing program at the time of initial engagement. This information may be self-reported by the presenting tenant if documentation or third-party confirmation of a federal housing subsidy is not available. Do not include short-term emergency rental assistance in HUD 52698 item 5d. Free text Describe the federal housing subsidy program if "Other" was selected for HUD 52698a item 31.
33 5e RentalAssist Has the presenting client sought emergency rental assistance? None Indicate whether the presenting tenant has sought short-term emergency rental assistance through any emergency rent relief program. Select one category that best reflects the presenting tenant’s circumstances at the time of initial engagement. This information may be self-reported by the presenting tenant if documentation or third-party confirmation is not available. Categorical Select the applicable category: Yes, applied for assistance; Yes, approved for or received assistance; Yes, but denied assistance; No; or Not applicable, no emergency rental assistance available
34 5f SameAddress Is the presenting tenant’s mailing address at the time of initial engagement the same as the unit address at issue in the pending or potential eviction matter? None Indicate whether, at the time of initial engagement, the presenting tenant receives mail at the physical rental housing unit at issue in the pending or potential eviction matter. Binary (Yes/No) Mark "yes" if, at the time of initial engagement, the presenting tenant receives mail at the physical rental housing unit at issue in the pending or potential eviction matter. If not, mark "no".
35 6 Provider Service Provider None Indicate name of grantee, subrecipient, or contractor providing service. Free text Enter the name of the service provider
36 7 PriService Primary Service
(select one category that best reflects the level of service provided)
None Select one category that best reflects the highest level of service provided at the time the matter is closed. Note that grantees are not required to use HUD 52698 for collecting or reporting information about tenant education and outreach services, referral services, court navigation services, or collaboration work to advance eviction prevention tools or programs. A description of those services, and associated accomplishments, must be reported in the grantee’s quarterly performance reports and HUD 52699.
Limited counsel and advice means ascertained or reviewed facts, exercised judgment in applying relevant law, and counseled tenant concerning his, her, or their legal problem.
Limited action/brief service means communications to a third party, preparation of a simple legal document, or assisting a pro se tenant with preparation of court or other legal documents.
Negotiated settlement without litigation means resolved tenant’s problem through negotiation and settlement without any court or administrative actions pending.
Negotiated settlement with litigation means resolved tenant’s problem through negotiation and settlement while a court or formal administrative action was pending, including when the court or administrative agency issues an order memorializing the settlement.
Administrative agency decision means represented tenant in an administrative agency action that resulted in a case-dispositive decision by the administrative agency or body after a hearing or other formal administrative process.
Court decision means represented tenant in a court proceeding that resulted in a case dispositive decision made by the court.
Extensive service not resulting in settlement or court or administrative action means assistance involving high level of factual complexity, highly sophisticated legal analysis, drafting of non-routine original pleadings or legal documents, or significant legal research.
Other post-eviction service has the meaning set forth in the HUD Eviction Protection Grant Program Notice of Funding Opportunity, unless otherwise captured by services defined above.
Categorical Select one category that best reflects the level of service provided: Limited counsel and advice; Limited action/brief service; Negotiated settlement without litigation; Negotiated settlement with litigation; Administrative agency decision; Court decision; Extensive service not resulting in settlement or court or administrative action; Other post-eviction service.
37 8a FH_Advice Eviction-Related Fair Housing or Civil Rights Service: Counsel and advice May be grouped with other Fair Housing or Civil Rights item Select the category or categories that reflect eviction-related fair housing or civil rights services provided during engagement in the tenant’s pending or potential eviction matter, if any.
Eviction-related counsel and advice means counsel and legal advice in relation to a fair housing and civil rights matter or filing a fair housing and civil rights complaint related to an eviction matter.
Binary (Yes/No) If the service provider provided eviction-related counsel and advice, mark "yes". If not, mark "no".
38 8a FH_Representation Eviction-Related Fair Housing or Civil Rights Service: Representation May be grouped with other Fair Housing or Civil Rights item Select the category or categories that reflect eviction-related fair housing or civil rights services provided during engagement in the tenant’s pending or potential eviction matter, if any.
Eviction-related representation means legal representation or limited representation in relation to a fair housing and civil rights matter or filing a fair housing and civil rights complaint related to an eviction matter.
Binary (Yes/No) If the service provider provided eviction-related representation, mark "yes". If not, mark "no".
39 8b ADR_Advocacy Alternative Dispute Resolution Service: Alternative dispute resolution advocacy May be grouped with other alternative dispute resolution item Select the category or categories that reflect alternative dispute resolution services provided during engagement in the tenant’s pending or potential eviction matter, if any.
Alternative dispute resolution advocacy means represented tenant, or assisted tenant with advocating for their interests, in an alternative dispute resolution process, whether participation was voluntary or ordered by a court.
Binary (Yes/No) If the service provider provided alternative dispute resolution advocacy, mark "yes". If not, mark "no".
40 8b ADR_Settlement Alternative Dispute Resolution Service: Alternative dispute resolution settlement agreement May be grouped with other alternative dispute resolution item Select the category or categories that reflect alternative dispute resolution services provided during engagement in the tenant’s pending or potential eviction matter, if any.
Alternative dispute resolution settlement agreement means assisted with resolving tenant’s problem through mediation, arbitration, conciliation, negotiation, transaction, or settlement memorialized by an agreement, whether or not a court or administrative agency issues an order memorializing the agreement.
Binary (Yes/No) If the service provider provided alternative dispute resolution settlement agreement, mark "yes". If not, mark "no".
41 9 OtherService Additional or Other Services Provided (briefly describe additional or other services provided) None Briefly describe additional services provided. If applicable, briefly explain “Other” activity or advocacy. Free text Briefly describe additional or other services provided
42 10a O_PreventEvictionFiling Prevented eviction filing May be grouped with other outcome items Select the category or categories that represent tenant outcomes at the time the matter is closed. Select all that apply. Attestation (Yes/Blank) If the Field Full Name represents a tenant outcome, mark "yes".
43 10a O_TenancyPreserved Tenancy preserved, tenant remained in home May be grouped with other outcome items Select the category or categories that represent tenant outcomes at the time the matter is closed. Select all that apply. Attestation (Yes/Blank) If the Field Full Name represents a tenant outcome, mark "yes".
44 10a O_LeaseRenewed Lease renewed May be grouped with other outcome items Select the category or categories that represent tenant outcomes at the time the matter is closed. Select all that apply. Attestation (Yes/Blank) If the Field Full Name represents a tenant outcome, mark "yes".
45 10a O_AdditionalDays Obtained additional days to move out May be grouped with other outcome items Select the category or categories that represent client outcomes at the time the matter is closed. Select all that apply. Attestation (Yes/Blank) If the Field Full Name represents a tenant outcome, mark "yes".
46 10a NumAddDays Number of additional days obtained May be grouped with other outcome items If "Obtained additional days to move out" is selected for HUD 52698a item 45, please indicate the number of additional days obtained. Numeric If the tenant obtained additional days to move out, indicate the number of days that were obtained. If the tenant did not obtain additional days to move out, then leave blank.
47 10a O_EvictDelay Eviction delayed or stayed May be grouped with other outcome items Select the category or categories that represent tenant outcomes at the time the matter is closed. Select all that apply. Attestation (Yes/Blank) If the Field Full Name represents a tenant outcome, mark "yes".
48 10a O_RemedyLockout Remedied lockout May be grouped with other outcome items Select the category or categories that represent tenant outcomes at the time the matter is closed. Select all that apply. Attestation (Yes/Blank) If the Field Full Name represents a tenant outcome, mark "yes".
49 10a O_AlternateHouse Secured alternate housing May be grouped with other outcome items Select the category or categories that represent tenant outcomes at the time the matter is closed. Select all that apply. Attestation (Yes/Blank) If the Field Full Name represents a tenant outcome, mark "yes".
50 10b O_DismissWithStips Eviction dismissed with stipulations May be grouped with other outcome items Select the category or categories that represent tenant outcomes at the time the matter is closed. Select all that apply. Attestation (Yes/Blank) If the Field Full Name represents a tenant outcome, mark "yes".
51 10b O_DismissNoStips Eviction case dismissed without stipulations May be grouped with other outcome items Select the category or categories that represent tenant outcomes at the time the matter is closed. Select all that apply. Attestation (Yes/Blank) If the Field Full Name represents a tenant outcome, mark "yes".
52 10c O_RentReduce Back rent or rental fees reduced or waived May be grouped with other outcome items Select the category or categories that represent tenant outcomes at the time the matter is closed. Select all that apply. Attestation (Yes/Blank) If the Field Full Name represents a tenant outcome, mark "yes".
53 10c O_RentAssist Secured or maintained short- or long-term housing assistance May be grouped with other outcome items Select the category or categories that represent tenant outcomes at the time the matter is closed. Select all that apply. Attestation (Yes/Blank) If the Field Full Name represents a tenant outcome, mark "yes".
54 10c O_OServiceBenefit Secured or maintained non-housing service or benefit May be grouped with other outcome items Select the category or categories that represent tenant outcomes at the time the matter is closed. Select all that apply. Attestation (Yes/Blank) If the Field Full Name represents a tenant outcome, mark "yes".
55 10c O_ReduceDamages Avoided or reduced holdover damages, landlord attorney fees, or other costs May be grouped with other outcome items Select the category or categories that represent tenant outcomes at the time the matter is closed. Select all that apply. Attestation (Yes/Blank) If the Field Full Name represents a tenant outcome, mark "yes".
56 10d O_RepairImprove Obtained repairs or improved housing conditions May be grouped with other outcome items Select the category or categories that represent tenant outcomes at the time the matter is closed. Select all that apply. Attestation (Yes/Blank) If the Field Full Name represents a tenant outcome, mark "yes".
57 10d O_RestoreUtilities Restored utilities May be grouped with other outcome items Select the category or categories that represent tenant outcomes at the time the matter is closed. Select all that apply. Attestation (Yes/Blank) If the Field Full Name represents a tenant outcome, mark "yes".
58 10d O_RecoverProperty Recovered personal property May be grouped with other outcome items Select the category or categories that represent tenant outcomes at the time the matter is closed. Select all that apply. Attestation (Yes/Blank) If the Field Full Name represents a tenant outcome, mark "yes".
59 10d O_RemedyDiscrimination Remedied discrimination May be grouped with other outcome items Select the category or categories that represent tenant outcomes at the time the matter is closed. Select all that apply. Attestation (Yes/Blank) If the Field Full Name represents a tenant outcome, mark "yes".
60 10d O_ObtainAccommodation Obtained a reasonable accommodation May be grouped with other outcome items Select the category or categories that represent tenant outcomes at the time the matter is closed. Select all that apply. Attestation (Yes/Blank) If the Field Full Name represents a tenant outcome, mark "yes".
61 10d O_PreventRetaliation Prevented or remedied retaliation May be grouped with other outcome items Select the category or categories that represent tenant outcomes at the time the matter is closed. Select all that apply. Attestation (Yes/Blank) If the Field Full Name represents a tenant outcome, mark "yes".
62 10d O_EnforcedORights Enforced other tenant rights May be grouped with other outcome items Select the category or categories that represent tenant outcomes at the time the matter is closed. Select all that apply. Attestation (Yes/Blank) If the Field Full Name represents a tenant outcome, mark "yes".
63 10e O_DefaultEvict Eviction default judgment May be grouped with other outcome items Select the category or categories that represent tenant outcomes at the time the matter is closed. Select all that apply. Attestation (Yes/Blank) If the Field Full Name represents a tenant outcome, mark "yes".
64 10e O_NotDefaultEvict Eviction judgment (not default) May be grouped with other outcome items Select the category or categories that represent tenant outcomes at the time the matter is closed. Select all that apply. Attestation (Yes/Blank) If the Field Full Name represents a tenant outcome, mark "yes".
65 10e O_Displacement Displacement without eviction judgment May be grouped with other outcome items Select the category or categories that represent tenant outcomes at the time the matter is closed. Select all that apply. Attestation (Yes/Blank) If the Field Full Name represents a tenant outcome, mark "yes".
66 10f O_AgreeSettle Negotiated agreement or settlement May be grouped with other outcome items Select the category or categories that represent tenant outcomes at the time the matter is closed. Select all that apply. Attestation (Yes/Blank) If the Field Full Name represents a tenant outcome, mark "yes".
67 10f O_EvictSealed Eviction record sealed or expunged May be grouped with other outcome items Select the category or categories that represent tenant outcomes at the time the matter is closed. Select all that apply. Attestation (Yes/Blank) If the Field Full Name represents a tenant outcome, mark "yes".
68 10f O_SatisfyJudgment Satisfaction of judgment May be grouped with other outcome items Select the category or categories that represent tenant outcomes at the time the matter is closed. Select all that apply. Attestation (Yes/Blank) If the Field Full Name represents a tenant outcome, mark "yes".
69 10f O_Other Other May be grouped with other outcome items Select the category or categories that represent tenant outcomes at the time the matter is closed. Select all that apply. Attestation (Yes/Blank) If the Field Full Name represents a tenant outcome, mark "yes".
70 10f O_Unknown Unknown May be grouped with other outcome items Select the category or categories that represent tenant outcomes at the time the matter is closed. Select all that apply. Attestation (Yes/Blank) If the tenant's outcome is unknown, mark "yes".
71 11 AdditionalOutcomes Additional or Other Outcomes (briefly describe additional or other outcomes) None Briefly describe additional outcomes. If applicable, briefly explain “Other” outcomes. Free text Briefly describe additional or other outcomes
72 12a TenantGoalsAcheived Was the presenting's desired outcome achieved None Qualify whether the outcome obtained at the time the matter is closed met the presenting tenant’s goals, as established in consultation with their lawyer or advocate, for resolution of their matter. The service provider listed in HUD 52698 item 6 is to determine whether the tenant’s goals were met based on their understanding of the tenant’s wishes and the legally available remedies. Categorical Select the applicable category: Yes, Partially, No, or Unknown.
73 12b TenantGoalsAcheived_D Explanation None Describe any factors or context needed to explain the provider’s response to HUD 52698 item 12a. For example, if the presenting tenant’s desired outcomes were only partially achieved or were not legally available based on the facts presented. Free text Enter an explanation to provide context, especially if "Partially" or "No" were selected for HUD 52698a item 72.
74 13 CaseDuration Case Duration - Number of days engaged None Indicate the number of days the service provider listed in HUD 52698 item 6 was engaged with the presenting tenant in this matter, from the time of initial engagement to the time the matter is closed. Numeric Enter a whole number. If the tenant engagement lasted less than a day, enter "1".

Sheet 4: ReferenceLists

PriService
Limited counsel and advice 
​​Limited action/brief service 
​​Negotiated settlement without litigation 
​​Negotiated settlement with litigation 
​​Administrative agency decision 
​​Court decision 
​​Extensive service not resulting in settlement or court or administrative action 
​​Other post-eviction service  
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