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): 52751		     		     
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: **

Delete page 3. This is the same information asked for on form 52753.

on p. 1 - in the instructions, delete the last sentence about section F.

p.1 - under A, move "PHA Code ________" to its own line and follow with "All applicants must identify a primary PHA"

p. 1 under A. following line above, please add a line as follows: Joint applicants indicate non-lead applicants:

PHA Name_______________ PHA Code_________________.

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