OMB83 C Change Worksheet

PAPERWORK REDUCTION ACT

CHANGE WORKSHEET

Agency/Subagency       Department of Education, Office of Special Education and Rehabilitative Services		OMB Control Number 1820 -0659
Enter only items that change Current Record New Record
Agency form number(s) Report of the Participation and Performance of Students with Disabilities on State Assessments	     	     
Annual reporting and record keeping hour burden
Number of respondents	60	60
Total annual responses	1	1
Percent of these responses collected electronically	97%	97%
Total annual hours	3,600	3,615
Difference		15***
Explanation of difference Program Change		0
Adjustment		15
Annual reporting and record keeping cost burden (in thousands of dollars)
Total annualized capital/startup Costs	0	0
Total annual costs (O&M)	0	0
Total annualized cost requested	0	0
Difference		0
Explanation of difference Program Change		0
Adjustment		0
Other change** Clarification and simplification of instructions for completing the data collection table. A few key definitions added. (Refer to bolded text.) No new data elements added. [More detailed memo of instruction edits is provided.] ***The additional 15 hours of respondent burden were approved when this form was cleared under #1820-0681 with the ‘Two Percent’ regs package. Those additional hours now are being included under the original data reporting form, #1820-0659..
S ignature of Senior Officer or designee:      	Date:      	For OIRA Use            

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

OMB 83-C