Form Hud 27061 H PDF Details

The HUD 27061-H form, known as the Race and Ethnic Data Reporting Form, serves a crucial function in the ambit of housing assisted by the U.S. Department of Housing and Urban Development. Mandated for both current tenants and applicants seeking housing assistance, this form plays a vital role in ensuring compliance with federal requirements relating to race and ethnic data collection. Developed with the intent to align with OMB-mandated changes for recording data, it facilitates a systematic approach for owners and managing agents to collect necessary demographics. The form not only categorizes ethnicity into Hispanic or Latino and not Hispanic or Latino but also offers five racial categories including American Indian or Alaska Native, Asian, Black or African American, Native Hawaiian or Other Pacific Islander, and White for individuals to self-identify. Additionally, it underscores the voluntary nature of this information, stating that there is no penalty for non-completion while emphasizing the importance of this data in fostering an inclusive and equitable approach to housing. Despite its seemingly straightforward intention, the form embodies a larger effort to ensure diversity and inclusivity within housing programs, symbolizing a step towards understanding and addressing the needs of various communities. Moreover, it specifies the process for submission and maintenance of these documents, signifying a move towards electronic data reporting in the future, enhancing efficiency and accessibility in housing program administration.

QuestionAnswer
Form NameForm Hud 27061 H
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesform hud 27061 h, hud 27061 h 2019, hud 27061, form hud 2706 h

Form Preview Example

Race and Ethnic Data Reporting Form

U.S. Department of Housing

OMB Approval No. 2502-0204

and Urban Development

(Exp. 5/31/2011)

Office of Housing

 

 

Name of Property

Project No.

Address of Property

 

 

 

 

 

 

 

 

 

 

Name of Owner/Managing Agent

 

 

Type of Assistance or Program Title:

 

 

 

 

 

 

 

 

 

 

Name of Head of Household

 

 

Name of Household Member

 

Date (mm/dd/yyyy):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Select

 

 

 

 

 

Ethnic Categories*

 

One

 

 

 

 

 

 

 

 

 

 

 

Hispanic or Latino

 

 

 

 

 

 

 

 

 

 

 

 

 

Not-Hispanic or Latino

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Select

 

 

 

 

 

Racial Categories*

 

All that

 

 

 

 

 

 

 

 

Apply

 

 

 

American Indian or Alaska Native

 

 

 

 

 

 

 

 

 

 

 

 

 

Asian

 

 

 

 

 

 

 

 

 

 

 

 

 

Black or African American

 

 

 

 

 

 

 

 

 

 

 

Native Hawaiian or Other Pacific Islander

 

 

 

 

 

 

 

 

 

 

 

 

 

White

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other

 

 

 

 

 

 

 

 

 

 

*Definitions of these categories may be found on the reverse side.

 

 

 

There is no penalty for persons who do not complete the form.

_____________________________________

____________________________

Signature

Date

Public reporting burden for this collection is estimated to average 10 minutes 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 information is required to obtain benefits and voluntary. HUD may not collect this information, and you are not required to complete this form, unless it displays a currently valid OMB control number.

This information is authorized by the U.S. Housing Act of 1937 as amended, the Housing and Urban Rural Recovery Act of 1983 and Housing and Community Development Technical Amendments of 1984. This information is needed to be incompliance with OMB-mandated changes to Ethnicity and Race categories for recording the 50059 Data Requirements to HUD. Owners/agents must offer the opportunity to the head and co- head of each household to “self certify’ during the application interview or lease signing. In-place tenants must complete the format as part of their next interim or annual re-certification. This process will allow the owner/agent to collect the needed information on all members of the household. Completed documents should be stapled together for each household and placed in the household’s file. Parents or guardians are to complete the self-certification for children under the age of 18. Once system development funds are provide and the appropriate system upgrades have been implemented, owners/agents will be required to report the race and ethnicity data electronically to the TRACS (Tenant Rental Assistance Certification System). This information is considered non-sensitive and does no require any special protection.

1

form HUD-27061-H (9/2003)

 

Instructions for the Race and Ethnic Data Reporting (Form HUD-27061-H)

A. General Instructions:

This form is to be completed by individuals wishing to be served (applicants) and those that are currently served (tenants) in housing assisted by the Department of Housing and Urban Development.

Owner and agents are required to offer the applicant/tenant the option to complete the form. The form is to be completed at initial application or at lease signing. In-place tenants must also be offered the opportunity to complete the form as part of the next interim or annual recertification. Once the form is completed it need not be completed again unless the head of household or household composition changes. There is no penalty for persons who do not complete the form. However, the owner or agent may place a note in the tenant file stating the applicant/tenant refused to complete the form. Parents or guardians are to complete

the form for children under the age of 18.

The Office of Housing has been given permission to use this form for gathering race and ethnic data in assisted housing programs. Completed documents for the entire household should be stapled together and placed in the household’s file.

1.The two ethnic categories you should choose from are defined below. You should check one of the two categories.

1.Hispanic or Latino. A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race. The term “Spanish origin” can be used in addition to “Hispanic” or “Latino.”

2.Not Hispanic or Latino. A person not of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.

2.The five racial categories to choose from are defined below: You should check as many as apply to you.

1.American Indian or Alaska Native. A person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment.

2.Asian. A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam

3.Black or African American. A person having origins in any of the black racial groups of Africa. Terms such as “Haitian” or “Negro” can be used in addition to “Black” or “African American.”

4.Native Hawaiian or Other Pacific Islander. A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

5.White. A person having origins in any of the original peoples of Europe, the Middle East or North Africa.

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form HUD-27061-H (9/2003)

 

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