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Implementation of the Violaence Against Women Reathorization Act 2013
Implementation of the Violence Against Women Reauthorization Act of 2013
OMB: 2577-0286
IC ID: 224769
OMB.report
HUD/PIH
OMB 2577-0286
ICR 202505-2577-001
IC 224769
( )
Documents and Forms
Document Name
Document Type
Form 5380
Implementation of the Violaence Against Women Reathorization Act 2013
Form
5380 Housing Rights for Victims
Final EOrev.2025.05.20 HUD-5380_clean.docx
Form
5381 MODEL EMERGENCY TRANSFER PLAN FOR VICTIMS OF DOMESTIC VI
Final EOrev.2025.05.20 HUD-5381_clean.docx
Form
5382 CERTIFICATION OF DOMESTIC VIOLENCE, DATING VIOLENCE, SEX
Final EOrev.2025.05.20 HUD-5382_clean.docx
Form
5383 EMERGENCY TRANSFER REQUEST FOR VICTIMS OF DOMESTIC VIOLE
Final EOrev.2025.05.20 HUD-5383_clean.docx
Form
HUD-5384 VAWA ET Data Collection Form
Final.2025.05.20 HUD-5384_clean.docx
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Implementation of the Violaence Against Women Reathorization Act 2013
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
5380
Housing Rights for Victims
Final EOrev.2025.05.20 HUD-5380_clean.docx
Yes
Yes
Fillable Fileable
Form
5381
MODEL EMERGENCY TRANSFER PLAN FOR VICTIMS OF DOMESTIC VIOLENCE, DATING VIOLENCE, SEXUAL ASSAULT, OR STALKING
Final EOrev.2025.05.20 HUD-5381_clean.docx
Yes
Yes
Fillable Fileable
Form
5382
CERTIFICATION OF DOMESTIC VIOLENCE, DATING VIOLENCE, SEXUAL ASSAULT, OR STALKING
Final EOrev.2025.05.20 HUD-5382_clean.docx
Yes
Yes
Fillable Fileable
Form
5383
EMERGENCY TRANSFER REQUEST FOR VICTIMS OF DOMESTIC VIOLENCE, DATING VIOLENCE, SEXUAL ASSAULT, OR STALKING
Final EOrev.2025.05.20 HUD-5383_clean.docx
Yes
Yes
Fillable Fileable
Form
HUD-5384
VAWA ET Data Collection Form
Final.2025.05.20 HUD-5384_clean.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Community and Regional Development
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
293,176
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
3 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
5,044,764
0
0
0
0
5,044,764
Annual IC Time Burden (Hours)
2,230,481
0
0
0
0
2,230,481
Annual IC Cost Burden (Dollars)
0
0
0
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.