83c

Paperwork Reduction Act

Change Worksheet

Agency/Subagency: U.S. Department of Housing and Urban Development			OMB Control Number: 2577-0269
Enter only items that change		Current Record		New Record**
Agency form number(s): HUD-424B, HUD 425, 4040-0013 GG
Annual reporting and keeping hour burden
	Number of respondents
	Total annual responses	440		440
	Percent of these responses collected electronically	    %		    %
	Total annual hours	4431		4431
	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			     
	Explanation of difference Program change Adjustment			           

Other change: **

Add forms covered by a different OMB information collection approval to the submissions an applicant for a Choice Neighborhoods grant will include:

1. HUD-424B Applicant and Recipient Assurances and Certifications (2501-0044, exp. 2/28/27)

2. 4040-0013 GG Certification Regarding Lobbying (4040-0013)

3. HUD 425 Certification of Consistency with Rural Partners Network Community Network Goals and Implementation (2501-0044, exp. 2/28/27)

Regarding the HUD-2530, add clarification statement that for purposes of a CN grant application, this is not a new filing. NOFO requests applicant provide a copy of most recent submission to HUD and thus there are no new burden hours to a CN applicant. Further, it is not applicable to most CN applicants.

Signature of Senior Official or Designee: X Wayne Eddins, 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