Signed 83C for 2577-0286

Paperwork Reduction Act
Change Worksheet
Agency/Subagency:

OMB Control Number:

U.S. Department of Housing and Urban Development

2577-0286
Implementation of the Violence
Against Women Reauthorization
Act of 2013

Enter only items that change

Current Record

New Record**

Agency form number(s):

HUD-5380, HUD-5381, HUD-5382, HUD-5383
Annual reporting and keeping hour burden
Number of respondents

N/A

N/A

Total annual responses

5,044,764

5,044,764

0%

0%

2,230,480.58

2,230,480.58

None

0

N/A

N/A

None

$0.00

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:

The incorrect versions of Forms HUD-5380, HUD-5381, HUD-5382, HUD-5383 were uploaded to ROCIS. The
copies that were approved were from October 2022 and the correct copies are from November 2024 that will be
uploaded to ROCIS.
This non-substantive change will have no impact on the information collection burden hours or costs.

Signature of Senior Official or Designee:

MITCHELL MARGESON

Date:

For OIRA Use

Digitally signed by: MITCHELL MARGESON
DN: CN = MITCHELL MARGESON C = US O = U.S. Government
OU = Department of Housing and Urban Development, Office of
Housing
Date: 2025.01.08 16:41:04 -05'00'

X Mitchell Margeson, Director, Paperwork Reduction Act Division

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

10/95