83 C Change Request

Paperwork Reduction Act

Change Worksheet

Agency/Subagency: U.S. Department of Housing and Urban Development			OMB Control Number: 2577-0226
Enter only items that change		Current Record		New Record**
Agency form number(s): HUD 50075-SM & HUD 50077-SL
Annual reporting and keeping hour burden
	Number of respondents	N/A		N/A
	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	N/A		N/A
	Total annual costs (O&M)	     		     
	Total annualized cost requested	     		     
	Difference			     
	Explanation of difference Program change Adjustment			           

Other change: **

The PHMOD is proposing the following non-substantive change to two forms in this collection:

HUD 50075-SM:

1. In form HUD 50075-SM, two plan elements and the associated instructions were removed to maintain compliance with the streamlined requirements found at §903.12. Specifically, in sub-section B.1(Year 5 submission) of the form, the elements of ‘Safety and Crime Prevention’ and ‘Pet Policy’ have been removed.

2. Also, the numbering for the sub-section B.1 (Years 1- 4 submissions) has also been updated to match the numbering convention used in the instruction, Specifically, B.2 and B.4 have been changes to B.1 and B. 2 respectively to be consistent with the numbering used in the instructions section.

HUD 50077-SL:

3. In form HUD 50077-SL, the signature line has been updated from inadvertently requiring the signature of the Executive Director and Board Chairperson to ‘Name of Authorized Official’.

These changes will have no impact on the information collection burden hours or costs.

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