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pdfPAPERWORK REDUCTION ACT
CHANGE WORKSHEET
Agency/Subagency
OMB Control Number
Education/OESE
1810-0036
Enter only items that change
Current Record
Agency form number(s)
NA
New Record
NA
Annual reporting and record keeping
hour burden
Number of respondents
250
250
Total annual responses
250
250
100%
100%
1500
1625
Percent of these responses
collected electronically
Total annual hours
Difference
125
Explanation of difference
Program Change
NA
Adjustment
Annual reporting and record keeping
cost burden (in thousands of dollars)
NA
Total annualized capital/startup
costs
NA
NA
Total annual costs (O&M)
NA
NA
Total annualized cost requested
NA
NA
Difference
NA
Explanation of difference
Program Change
NA
Adjustment
NA
Other change**
Change is required to support the applicants in preparing accurate information for Table 1 of the application, the
estimated value of the Federal property, to meet the requirements of the new regulations.
Signature of Senior Officer or
designee:
Date:
For OIRA Use
,
**This form cannot be used to extend an expiration date
OMB 83-C
| File Type | application/pdf |
| File Title | OMB Form 83C |
| Subject | Clearance Package change worksheet |
| Author | Dorris Thurmond |
| File Modified | 2009-10-07 |
| File Created | 2009-10-07 |