83c

Paperwork Reduction Act

Change Worksheet

Agency/Subagency: U.S. Department of Housing and Urban Development			OMB Control Number: 2506-0197
Enter only items that change		Current Record		New Record**
Agency form number(s): HUD 4135 & HUD 4136, HUD 4137, HUD 4139, & HUD 4140		     		     
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: **

non-substantial change No change in burden

Two closeout forms were approved through our NOFA PRA last year. I would potentially like to amend them -  with very simple changes.

• The certification form is complicated and asks questions in positive and negative – one question would be better. It looks like  a lot of change but really isn’t. HUD 4135

The property form has a wrong instruction. It tells folks to “skip to Part II” when they should just skip that whole section HUD 4136

No changes to the burden hours, this form was including on the supporting statement, but forgot to upload in the IC

Community Compass - Work Plan – Administration HUD 4140

Community Compass - Work Plan – Coordination HUD 4137

Community Compass – Work Plan (other than Administration or Coordination) HUD 4139

Signature of Senior Official or Designee: X Lillian L. Deitzer, 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