Signed OMB 83-C Form for HUD-94000-ADD-ORCF (New Jersey)

Paperwork Reduction Act
Change Worksheet
Agency/Sub agency:

OMB Control Number:

U.S. Department of Housing and Urban Development

2502-0605

Enter only items that change
Agency form number(s):

Current Record

N/A

HUD-94000-ADD-ORCF (New Jersey)

New Record**

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-94000-ADD-ORCF (New Jersey) to OMB:
Scrivener’s error. Healthcare form, but in the second paragraph, “Multifamily” is used instead of “Healthcare.”
OGC reviewed and determined it was non-substantive.
NO additional burden hours will be added.

Signature of Senior Official or Designee:

Date:

For OIRA Use

4/10/2024
John Hartung, Director, Policy, Risk Analysis and Lender Relations
Division, Office of Residential Care Facilities, HP

** This form cannot be used to extend an expiration date.
OMB 83-C

10/95