Signed 83C form for HUD-92476C

Paperwork Reduction Act

Change Worksheet

Agency/Sub agency: U.S. Department of Housing and Urban Development			OMB Control Number: 2502-0605
Enter only items that change		Current Record		New Record**
Agency form number(s): HUD-92476C-ORCF		N/A		N/A
Annual reporting and keeping hour burden
	Number of respondents			     
	Total annual responses	     		     
	Percent of these responses collected electronically	    %		    %
	Total annual hours	     		     
	Difference	0		     
	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	0		     
	Explanation of difference Program change Adjustment			           

Other change: **

Here explain/describe the changes to HUD-92476C-ORCF form to OMB:

The erroneous reference to three months is inconsistent with current longstanding policy and with Program Obligations in Handbook 4232, Section 2 at 2.5.NN, which requires an underwritten debt service coverage “for a twelve month period.”

Signature of Senior Official or Designee: John Hartung, Director, Policy, Risk Analysis and Lender Relations Division, Office of Residential Care Facilities, HP

Date: 10/18/19

For OIRA Use

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

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OMB 83-C 10/95