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ni i; n U.S. Department of Housing OMB Approvel No. 2577-015
Periodic Estimate and Urban Development 7 (xp. 1/31/2027)
for Partial Payment Office of Public and Indian Housing
Submit original and one copy to the Public Housing Agency.
Complete instructions are on the back of this form.
Public reporting burden for this collection of information is estimated to average 3.5 hours per response, including the time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. HUD may not conduct or sponsor, and an applicant is not
tequired to respond to 4 collection of information unless it displays a currently valid OMB control number. Comments regarding the accuracy of this burden estimate and any
suggestions for reducing this burden can be sent to the Reports Management Officer, Office of Policy Development and Research, REE, Depertment of Housing and Uroan
Development, 451 7th St SW, Room 4176, Washington, DC 20410-5000. When providing comments, please refer te OMB Approvat No, 2577-0157. This information is collected
unger the authority of Section 6(c) of the U.S Housing Act of 1937 and HUD regulations. HAs are responsible for contract administration to ensure that the work for project
development is done in accordance with State laws and HUD requirements. The contractor/subconiractor reports provide details and summaries on payments, change orders, and
schedule of materials stored for the project. The information will be used to ensure that the total development costs, identified in the ACC, are kept as low as possible end consistent with
HUD construction requirements. Responses to the collection are necessary to obtain a bene’it. The information requested does not lend itself to confidentiality.
Name of Public Housing Agency Periodic Estimate Number Period
From (mmidd/yyyy) To (mm/dd/yyyy)
Location of Project Project Number
Name of Contactor Contract Number
Item Number Description of Item Completed to Date
@ Q 9
$
Value of Contract Work Completed to Date (Transfer this total to line 5 on back of this sheet) $
Previous editions are obsolete form HUD-51901 (1/2014)Jump to an indexed page (88 of 88)