Jobs Plus Pilot Program

Documents and Forms

Document Name Document Type
Form HUD Form 50153 Jobs Plus Pilot Program Form and Instruction
HUD Form 50153 Certification of Consistency with Promise Zone Goal and Final - HUD Form - 50153.pdf Form and Instruction
HUD Form 424B Applicant and Recipient Assurances and Certifications Final - HUD Form 424B-v2.pdf Form and Instruction
HUD Form 2880 Applicant/Recipient Disclosure/Update Report Final - HUD Form 2880.pdf Form and Instruction
HUD Form 2991 Certification of Consistency with the Consolidated Plan Final - HUD Form 2991.pdf Form and Instruction
HUD Form 2996 Certification for Opportunity Zones Preference Points Final - HUD Form 2996.pdf Form and Instruction
HUD Form 50070 Certification for a Drug-Free Workplace Final - HUD Form 50070.pdf Form and Instruction
HUD Form 50144 Jobs Plus Budget Final - HUD Form 50144 JobPlus Budget _.xlsx Form and Instruction
HUD Form 1044 Assistance Award/Amendment Final - HUD Form-1044 Form.pdf Form and Instruction
SFLLL Disclosure or Lobbying Activities Final - SFLLL.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Jobs Plus Pilot Program	Agency IC Tracking Number:	2577-NEW

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	HUD Form 50153	Certification of Consistency with Promise Zone Goal and Implementation	Final - HUD Form - 50153.pdf	Yes	Yes	Fillable Fileable Signable
Form and Instruction	HUD Form 424B	Applicant and Recipient Assurances and Certifications	Final - HUD Form 424B-v2.pdf	Yes	Yes	Fillable Fileable Signable
Form and Instruction	HUD Form 2880	Applicant/Recipient Disclosure/Update Report	Final - HUD Form 2880.pdf	Yes	Yes	Fillable Fileable Signable
Form and Instruction	HUD Form 2991	Certification of Consistency with the Consolidated Plan	Final - HUD Form 2991.pdf	Yes	Yes	Fillable Fileable Signable
Form and Instruction	HUD Form 2996	Certification for Opportunity Zones Preference Points	Final - HUD Form 2996.pdf	Yes	Yes	Fillable Fileable Signable
Form and Instruction	HUD Form 50070	Certification for a Drug-Free Workplace	Final - HUD Form 50070.pdf	Yes	Yes	Fillable Fileable Signable
Form and Instruction	HUD Form 50144	Jobs Plus Budget	Final - HUD Form 50144 JobPlus Budget _.xlsx	Yes	Yes	Fillable Fileable Signable
Form and Instruction	HUD Form 1044	Assistance Award/Amendment	Final - HUD Form-1044 Form.pdf	Yes	Yes	Fillable Fileable Signable
Form and Instruction	SFLLL	Disclosure or Lobbying Activities	Final - SFLLL.pdf	Yes	Yes	Fillable Fileable Signable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 103	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	103	0	103
Annual IC Time Burden (Hours)	6,432	-141	6,573
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.