83c

Paperwork Reduction Act

Change Worksheet

Agency/Subagency: U.S. Department of Housing and Urban Development			OMB Control Number: 2529-0033
Enter only items that change		Current Record		New Record**
Agency form number(s): 424, 424CBW (Detailed Budget), 424CB (Budget), 2880, SF-LLL (Lobbying Certificate), HUD-27061 (Race & Ethnic Data Reporting), HUD-96010 (Logic Model), HUD-904A (Type of Closure), HUD-904B (Bases and Issues Test), HUD-904C (Bases and Issues of Reports of Discrimination), Certification of Consistency with Consolidated Plan, Acknowledgement of Receipt of Application, Survey on Ensuring Equal Opportunity for Applicants, Grant Application Survey, 3rd Party Documentation Fax Transmittal		     		     
Annual reporting and keeping hour burden
	Number of respondents	1,076		     
	Total annual responses	1,786		     
	Percent of these responses collected electronically	100 %		    %
	Total annual hours	50,536.00		     
	Difference			     
	Explanation of difference Program change Adjustment			           
Annual reporting and recordkeeping cost burden (in thousands of dollars)
	Total annualized Capital/Startup costs	$0.00		     
	Total annual costs (O&M)	$0.00		     
	Total annualized cost requested	$0.00		     
	Difference			     
	Explanation of difference Program change Adjustment			           

Other change: **

This non-substantive change clarifies that as part of the burden hours calculated for Application Development, the burden hours address all required forms, rating factor narratives, supplemental charts and forms, and required FHEO narratives (i.e., civil rights and racial equity narratives) included in the Notice of Funding Opportunity (NOFO). There are no changes to the annual reporting and recordkeeping burden hours resulting from this clarification.

Agency required forms include: HUD 27061, HUD 904-A, HUD 904-B, HUD 904-C, SF-424, HUD-424B, SF-424B, SF-424CB, SF-424CBW, HUD-2880, SF LLL, HUD 96010, Certification Regarding Lobbying Activities, Federal Assistance Representations and Certifications, HUD-50153 (If applicant wants consideration for points), Minority Servicing Institutions supporting documentation (if applicant wants consideration for points).

In addition to rating factor narratives, applicants are required to submit civil rights related and advancing racial equity narratives.

Signature of Senior Official or Designee: Stephanie W. Thomas, FHIP Director X

Date:

For OIRA Use

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

OMB 83-C 10/95