83c Change Request

Paperwork Reduction Act

Change Worksheet

Agency/Subagency: U.S. Department of Housing and Urban Development Office of Public and Indian Housing			OMB Control Number: 2577-0178
Enter only items that change		Current Record		New Record**
Agency form number(s): Family Self-Sufficiency (FSS) Program Coordinator Funding Form HUD-52651				Changes are recorded below
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 No change 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 No change Program change Adjustment			           

Other change: **

1. Public Reporting Statement: changes the regulatory reference from 24 CFR 982.302(b) to 24 CFR 984.302.

2. Part I: the following items have been removed: “applicant category”, “type of FSS program”, “MTW agency”, “DUNS number”, and “funding request for FY.”

3. Part I: Section A becomes Section B.

4. Part I: section C. (formerly section B.), the following items have been removed: “address”, “city”, “county”, “state”, “zip code.”

5. Part I: sections on salary comparability and contact information (formerly sections C. and D.) have been removed.

6. Part II.A: the following columns have been removed: “FY last funded”, “salary amount last funded,” and “is applicant’s request above percentage...”

7. Part II: the following note is removed: “salary awards will not exceed the cap per position stated in the most recent NOFA.”

8. Part III: the following note is removed: “salary awards will not exceed the cap per position stated in the most recent NOFA.”

9. Instructions Page: adds statement A.

10. Instructions Page: removes instructions for Part I “funding requested for fiscal year.”

11. Instructions Page: removes the first two statements for Part II.A “previously funded positions.”

These changes won’t have an impact on the burden hours for this information collection.

Signature of Senior Official or Designee: X Colette Pollard, Departmental Reports Management Officer, OCIO

Date:

For OIRA Use

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

OMB 83-C 10/95