OMB 83-c

Paperwork Reduction Act

Change Worksheet

Agency/Subagency: U.S. Department of Housing and Urban Development      			OMB Control Number: 2577-0229
Enter only items that change		Current Record		New Record**
Agency form number(s): 52755		     		     
Annual reporting and keeping hour burden
	Number of respondents	     		     
	Total annual responses	     		     
	Percent of these responses collected electronically	    %		    %
	Total annual hours			     
	Difference			     
	Explanation of difference Program change Adjustment			           
Annual reporting and recordkeeping cost burden (in thousands of dollars)
	Total annualized Capital/Startup costs	     		     
	Total annual costs (O&M)	     		     
	Total annualized cost requested	     		     
	Difference			     
	Explanation of difference Program change Adjustment			           

Other change: **

Page 1, second paragraph, second line under “I. General Terms”, remove reference to “Neighborhood Networks (NN)” and insert the word “grant”.

Page 1, fourth paragraph, first line under section “I. General Terms”, remove “/NN”.

Page 1, first paragraph, second line, under section “II. Roles and Responsibilities”, remove “or NN”.

Signature of Senior Official or Designee: X Lillian Deitzer, Departmental Reports Management Officer, OCIO

Date:

For OIRA Use

** This form cannot be used to extend an expiration date.

OMB 83-C 10/95