83c Change Request Worksheet

Paperwork Reduction Act

Change Worksheet

Agency/Subagency: U.S. Department of Housing and Urban Development Office of Public and Indian Housing			OMB Control Number: 2577-0200
Enter only items that change		Current Record		New Record**
Loan Guarantees for Indian Housing Form HUD-50131
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: **

1. Removes text above fillable section that provides option to fax in submission by applicants.

2. Breaks out Field #1, Lender Name and TIN #, into two separate fillable sections

3. Adds a Field (Field # 4) to provide Lender Sponsor if applicable

4. Changes Field #4 (Field #5 in revised form) into a selectable check box

5. Changes Field #6 (Field #7 in revised form) into a selectable check box

6. Breaks out Field #7 (Fields #8 & #9) in revised form) by First Name, Middle Initial, Last Name and Tribal Affiliation fillable sections.

7. Adds the “Number of Units” Question to Field #10 (Field #12 in revised form)

8. Changes Field #11’s (Field #13 in revised form) Initial question into a check box (everything else remains the same).

9. The current form is a basic word document that can be filled in electronically but when typing in document, changes the format of document (i.e. when you type the underlines move to the right and next line if it reaches the end. The new format being presented only allows the user to fill in text boxes so that the format remains constant when users fill it out. It essentially streamlines a user’s ability to fill out the form.

10. Also created a PDF version of the form that provides even more intuitive features (i.e. ability to tab over each area that a user can fill out, type in phone numbers and automatically formats the number once fully entered)

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