83 C

Paperwork Reduction Act

Change Worksheet

Agency/Subagency: U.S. Department of Housing and Urban Development			OMB Control Number: 2502-0005
Enter only items that change		Current Record		New Record**
Agency form number(s):      N/A		     		     
Annual reporting and keeping hour burden
	Number of respondents	N/A		     
	Total annual responses	N/A		     
	Percent of these responses collected electronically	    %		    %
	Total annual hours	N/A		     
	Difference			     
	Explanation of difference Program change Adjustment			N/A      
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	N/A		      N/A

Other change: **

The Annual certification document was not uploaded. It was titled correctly but not uploaded

Signature of Senior Official or Designee: X Wayne Eddins, Departmental Paperwork Reduction Act Officer, OCIO

Date:

For OIRA Use

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

OMB 83-C 10/95