Form Hud-51234 - Report On Occupancy For Public And Indian Housing - U.s. Department Of Housing And Urban Development

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U.S. Department of Housing and Urban Development
OMB Approval No. 2577-0028 (exp. 5/31/2001)
Report on Occupancy
Office of Public and Indian Housing
for Public and Indian Housing
This collection of information is authorized by Section 6(c) of the U.S. Housing Act of l937, as amended. Under the ACC, Housing Agencies must assist low-income residents. The information enables
HUD to monitor the rate and extent at which the Low-Income Public Housing Program is being used by HAs to assist low-income families HUD will use the occupancy information to monitor units vacant,
demolished, boarded-up, under repair/modernization/rehabilitation, or converted to a non-dwelling status to provide an accurate inventory of HA project units and their disposition.. Responses to the
collection of information are mandatory and required to obtain a benefit. The information requested does not lend itself to confidentiality.
Public reporting burden for this collection of information is estimated to average 1 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. 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.
Read the instructions in Handbook 7465.3 completely before starting
1. Name of PHA / IHA :
2. Report Date (mm/dd/yyyy):
this form. Enter information on a separate line for each address and site
code for each project. If you need assistance, contact your local HUD
Office.
3.
4.
5.
6.
7.
8.
9.
10.
11.
Total Units
Total Units
Project
Project
Total
Total
Total
Total Units
Total
Occupied by
Occupied by
Name
Number
Project
Employee
Non-Dwelling
Available for
Vacant
Low Income
Elderly Low
Units
Units
Units
Occupancy
Units
Tenants
Income Tenants
Signature of PHA Official :
Title of Official :
12. PHA / IHA Verification :
The information on this form has
Phone Number :
Date Prepared :
been verified and is accurate to the
X
(
)
best of my knowledge.
ref. Handbook 7465.3
form HUD-51234 (5/92)
The 1/92 edition may also be used: all other previous editions are obsolete.
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