OMB 83-C PRA Change Worksheet

Paperwork Reduction Act

Change Worksheet

Agency/Subagency: U.S. Department of Housing and Urban Development			OMB Control Number: 2577-0169
Enter only items that change		Current Record		New Record**
Agency form number(s): HUD-2880, HUD-2993, HUD-96011, HUD-2991, SF-424, SF-LLL		     		     
Annual reporting and keeping hour burden
	Number of respondents
	Total annual responses	3,011,426		3,012,426
	Percent of these responses collected electronically
	Total annual hours	1,069,683		1,070,603
	Difference			+920
	Explanation of difference Program change Adjustment			Adjustment
Annual reporting and recordkeeping cost burden (in thousands of dollars)
	Total annualized Capital/Startup costs	0		0
	Total annual costs (O&M)	0		0
	Total annualized cost requested	0		0
	Difference			0
	Explanation of difference Program change Adjustment			NA

Other change: **

This change reflects additional burden hours related to completing an SF-424 and SF-LLL, where applicable, when a public housing agency submits an application for funding of new Housing Choice Vouchers pursuant to the publication of a Notice of Funding Availability, which is occasional. The SF-424 and SF-LLL require a minimal increase in burden hours to 2577-0169, which is reflected on this Change Request.

The burden hours for the Funding Application (HUD-52515) used by PHAs to apply for new vouchers are already covered under OMB Control Number 2577-0169. What is not covered are the standard and HUD forms noted above, which are certifications or other document types without a burden, or forms with burden hours for all anticipated respondents approved under a separate OMB approval number, and required for inclusion in an application for new vouchers.

The current number of 1,000 respondents or PHAs in 2577-0169 for the HUD-52515 is sufficient to capture these occasional allotments of new vouchers, which currently includes vouchers provided under Mainstream, Designated Housing, and Certain Developments Notices of Funding Availability (NOFAs). The percent of responses collected electronically for this extremely small proportion of the entire suite of forms in 2577-0169 will be close to 100% with the existence of Grants.gov for submitting applications for federal assistance electronically, but will not materially alter the current percentage of forms in the administration of the voucher program to be collected electronically overall.

Description of Information Collection	Number of Respondents	Responses per Year	Total Applications	Hrs per Response	Total Hours
PROGRAM FORMS
HUD 52515 Program Funding Application (2577-0169)
HUD 50058 Family Report Form (2577-0083)
STANDARD FORMS
SF424 (0348-0043) Application for Federal Assistance	1,000	1		.75	750
SFLLL (0348-0046) Lobbying Form	1,000	1		.17	170
HUD 2880 (2510-0011) Applicant Disclosure				0
HUD 2991 Certification of Consistency w/Cons Plan				0
HUD 2993 Acknowledgement of Application Receipt				0
HUD 96011 (2535-0118) 3rd Party Doc. Fax Transmittal				0
Subtotal (Application)				.92
Total	1,000		1,000		920

Signature of Senior Official or Designee: X Lillian Deitzer, Departmental Paperwork Reduction Act Officer, OCIO

Date:

For OIRA Use

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

OMB 83-C 10/95