Supplementary Documenyt

83c Change Worksheet-HUD Form 50143_Reservation of Funds Request Form for OLG.doc

Loan Guarantees for Indian Housing

Supplementary Documenyt

OMB: 2577-0200

Document [doc]
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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**

HUD-50143 – Section 184 Direct Guarantee Reservation of Funds Request



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. Removed entire DG certification section (bottom section)

  2. Added Sales Price or Acquisition Cost to financial information table

  3. Added the verbiage “DG” to line four “Underwriter Name” request.

  4. Added the verbiage “Monthly” to Other in table.



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

File Typeapplication/msword
File TitlePaperwork Reduction Act
AuthorPreferred User
Last Modified ByArlette Annette Mussington
File Modified2016-01-15
File Created2016-01-15

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