HUD-53246 Reference

U.S. Department of Housing

and Urban Development

Office of Public and Indian Housing

(exp. 07/31/2025)

OMB Approval No. 2577-0218

C ost Summary – Discontinued, Replaced

I ndian Housing Block Grant

See Instructions and Public Reporting Statement on back.

1. Name of Applicant (as shown in Item 5, Standard Form 424)			2. Application/Grant Number (to be assigned by HUD upon submission)
3. ✔ Original Revision (check here if this is the (check here if submitted first submission to HUD) with implementation schedule as part of pre-award requirements		Amendment (check here if submitted after HUD approval of grant)			Date (mm/dd/yyyy)
4.
						$0.00
						$0.00
						$0.00
						$0.00
						$0.00
						$0.00
						$0.00
						$0.00
						$0.00
						$0.00
						$0.00
						$0.00
5. Administration	$0.00					$0.00
	$0.00					$0.00
	$0.00					$0.00
Administration Total	$ 0.00	$ 0.00		$ 0.00		$ 0.00
6. Sub Total Enter totals of columns b, c, and d.	$ 0.00	$ 0.00		$ 0.00
7. Grand Total Enter sum of columns b, c, and d.						$ 0.00

Public reporting burden for this collection of information is estimated to average 2 hours 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. This agency may not collect this information, and you are not required to complete this form, unless it displays a currently valid OMB control number.

This collection of information requires that each eligible applicant submit information to enable HUD to select the best projects for funding during annual competitions for the IHBG Competitive Program. The information will be used by HUD to determine whether applications meet minimum screening eligibility requirements and application submission requirements. Applicants provide general information about the project which is preliminary to the review of the applicant’s response to the criteria for rating the application. The information is essential for HUD in monitoring grants to ensure that grantees are making proper use of Federal dollars. Responses to the collection are required by Section 105 of the Department of Housing and Urban Development Reform Act (P.L. 101-235) as amended by the Cranston-Gonzales National Affordable Housing Act of l990. The information requested does not lend itself to confidentiality.

Previous editions are obsolete

form 53246 (6/2018)

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