Family Self-Sufficiency Program (FSS)

Documents and Forms

Document Name Document Type
Form HUD-52650 Family Self-Sufficiency Program (FSS) Form and Instruction
FSS PBRA Reporting Tool HUD-XXXXX 8-14-25.xlsx Instruction
HUD-52650 Family Self-Sufficiency (FSS) Program Contract of Partic Final - HUD Form-52650 FSS CoP.docx Form and Instruction
HUD-2880 Applicant/Recipient Disclosure/Update Report 2880 8-14-25.pdf Form and Instruction
HUD-52651 Family Self-Sufficiency (FSS) Program Coordinator Fundin Final - HUD Form 52651 Application.docx Form and Instruction
424B Applicant and Recipient Assurances and Certifications 424B 8-14-25.pdf Form and Instruction
SF-424 Application for Federal Assistance SF424 8-14-25.pdf Form and Instruction
SF-425 Federal Financial Report SF425 8-14-25.pdf Form and Instruction
SFLLL Disclosure of Lobbying Activities SFLLL 8-14-25.pdf Form and Instruction
52651-B FSS Monitoring Review Tool Final - HUD Form-52651-B FSS Monitoring Review Tool.docx Form and Instruction
52651-C FSS Annual Survey Final HUD Form-52651-C FSS Annual Survey.docx Form and Instruction
50058 Family Repor Family Report HCV-Sec Moderate Rehabiliation Program HUD-50058 Family Report HCV-Sec Moderate Rehabilitation Program 8-14-25.docx Form and Instruction
50058 MTW Expansio MTW Expaansion Family Report PH-HCV HUD-50058 MTW Expansion Family Report PH-HCV 8-14-25.docx Form and Instruction
50058 Family Repor MTW Family Report HUD-50058 MTW Family Report 8-14-25.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Family Self-Sufficiency Program (FSS)	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 23(g) (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	HUD-52650	Yes	Yes	Fillable Fileable Signable
Form and Instruction	HUD-2880	Yes	Yes	Fillable Fileable Signable
Form and Instruction	HUD-52651	Yes	Yes	Fillable Fileable Signable
Form and Instruction	424B	Yes	Yes	Fillable Fileable Signable
Form and Instruction	SF-424	Yes	Yes	Fillable Fileable Signable
Form and Instruction	SF-425	Yes	Yes	Fillable Fileable Signable
Form and Instruction	SFLLL	Yes	Yes	Fillable Fileable Signable
Form and Instruction	52651-B	Yes	Yes	Fillable Fileable Signable
Form and Instruction	52651-C	Yes	Yes	Fillable Fileable Signable
Instruction		Yes	Yes	Fillable Fileable Signable
Form and Instruction	50058 Family Report	Yes	Yes	Fillable Fileable Signable
Form and Instruction	50058 MTW Expansion	Yes	Yes	Fillable Fileable Signable
Form and Instruction	50058 Family Report	Yes	Yes	Fillable Fileable Signable

Line of Business: Community and Social Services

Subfunction: Homeownership Promotion

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5,450	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	28,810	28,070	740
Annual IC Time Burden (Hours)	39,520	-27,730	67,250
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.

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