Supplemental Document

Paperwork Reduction Act

Change Worksheet

Agency/Subagency: U.S. Department of Housing and Urban Development Office of Public and Indian Housing			OMB Control Number: 2577-0200
Enter only items that change		Current Record		New Record**
Agency form number(s) Section 184 Indian Loan Guarantee Program Endorsement Submission Case Binder Assembly		Form HUD-50123
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: **

1. Good Faith Estimate was removed and replaced with the TILA-RESPA Integrated Disclosure Form which has been mandated by the Consumer Financial Protection Bureau (CFPB).

2. Final Truth in Lending Disclosure was removed and replaced with the TILA-RESPA Integrated Disclosure Form which has been mandated by the Consumer Financial Protection Bureau (CFPB).

These certification changes will have no significant impact on information collection burden.

Signature of Senior Official or Designee: X Colette Pollard, Departmental Reports Management Officer, OCIO

Date:

For OIRA Use

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

OMB 83-C 10/95