Form Hud-51001 - Periodic Estimate For Partial Payment

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U.S. Department of Housing

Periodic Estimate for

OMB Approval No. 2577-0157

(exp. 12/31/2011)

and Urban Development

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. This agency may

not conduct or sponsor, and a person is not required to respond to, a collection of information unless that collecton displays a valid OMB control number.

This information is collected under the authority of Section 6(c) of the U.S Housing Act of l937 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/subcontractor

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 and consistent with HUD construction requirements. Responses to

the collection are necessary to obtain a benefit. The information requested does not lend itself to confidentiality.

Name of Public Housing Agency

Periodic Estimate Number

Period

From

(mm/dd/yyyy)

Location of Project

Project Number

Name of Contractor

Contract Number

Item Number