83c OMB 2577-0266

Paperwork Reduction Act

Change Worksheet

Agency/Subagency: U.S. Department of Housing and Urban Development			OMB Control Number: 2577-0026
Enter only items that change		Current Record		New Record**
Agency form number(s): HUD-52574		     		     
Annual reporting and keeping hour burden
	Number of respondents	3,000		3,000
	Total annual responses	13,800		13,800
	Percent of these responses collected electronically	100%		100%
	Total annual hours	11,310		11,310
	Difference			0.00
	Explanation of difference Program change Adjustment			No difference
Annual reporting and recordkeeping cost burden (in thousands of dollars)
	Total annualized Capital/Startup costs	0.00		0.00
	Total annual costs (O&M)	0.00		0.00
	Total annualized cost requested	0.00		0.00
	Difference			0.00
	Explanation of difference Program change Adjustment			No difference

Other change:

• Corrected the OMB approval number.

• Updated the address to send comments regarding the burden estimate.

• Added space for the Public Housing Agency to provide optional comments.

• Revised the forms signatory to include the Public Housing Agency’s Executive Director.

• This non-substantive change has no impact on the information collection burden hours or costs.

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