PRA Change Worksheet

Paperwork Reduction Act

Change Worksheet

Agency/Subagency: U.S. Department of Housing and Urban Development OPHI			OMB Control Number: 2577-0229
Enter only items that change		Current Record		New Record**
Agency form number(s): HUD-52768 & HUD-52769		     		     
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: **

HUD-52768

Page 1 -

Separated PHA name and PHA code requests into two separate questions.

Expanded question on type of applicant to include non-profit and faith-based

Asked two yes/no questions regarding previous awards

Page 2 -

Changed language in second column heading

HUD-52769

eliminated PHA code

changed language on need column

clarified language on signature

Signature of Senior Official or Designee: X Wayne Eddins, Departmental Reports Management Officer, OCIO

Date:

For OIRA Use

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

OMB 83-C 10/95