Correspondence

Change Request	U.S. Department of Housing

and Urban Development

Executive Secretariat

Program Area:

ACORN Control No.:

Request Submitted by:

Correspondence From:

Telephone Number:

Incoming Correspondence Date: (mm/dd/yyyy)
Change Action Requested:
Acknowledgment Date, if any:
No Action Requested (NAR)

Extension and New Date

Interim Date, if any:
Downgrade(s) to:

Transfer to:

Today's Date:
Other:

Number of Previous Extensions: Original Due Date: Current Due Date:

Reason for Requested Change:

Program Office

Correspondence Unit Chief:

Initials Date

Approving Principal:

Signature Date

Congressional Correspondence

Approved

Modified

Disapproved, proceed as directed on control slip

Approving Principal:

Signature Date

Request Status:

Approved

Modified

Disapproved, proceed as directed on control slip

_________________________________	_____________

Director, Executive Secretariat	Date

form HUD-149 (2/03)

Correspondence

Edgar L. Kapfer

2003-01-07

H12097

ATS