83-c

Paperwork Reduction Act

Change Worksheet

Agency/Subagency: U.S. Department of Housing and Urban Development, Office of Lead Hazard Control and Healthy Homes			OMB Control Number: 2539-0026
Enter only items that change		Current Record		New Record**
Agency form number(s):      		     		     
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: **

      No changes to Annual reporting and recordkeeping hour burden or to Annual reporting and recordkeeping cost burden.

The change to the AHHS II involves only additional analyses for PFOS and PFOS to be performed by the EPA on water and dust samples already collected. All field work was completed in June, 2019.

We attach the EPA plans for the analyses. (“Responses to Questions/Issues Discussed with OMB on November 27, 2019”)

Signature of Senior Official or Designee: X

Date:

For OIRA Use

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

OMB 83-C 10/95