Fr 4102 83-c

PAPERWORK REDUCTION ACT
CHANGE WORKSHEET
Agency/Subagency

OMB control number

Board of Governors of the Federal Reserve System

7

1

0

0

-

0

0

9

9

Enter only items that change
Current Record

New Record

3

3

6

3

Agency form number(s)

FR 4102
Annual reporting and recordkeeping
hour burden
Number of respondents
Total annual responses
Percent of these responses
collected electronically

1,140

Total annual hours

210

(930)

Difference
Explanation of difference:

%

%

Program change

(930)

Adjustment
Annual reporting and recordkeeping
cost burden (in thousands of dollars)
Total annualized Capital/Startup costs
Total annual costs (O&M)
Total annualized cost requested
Difference
Explanation of difference:

Program change
Adjustment

Other Change**
Decrease in burden hours reflects the removal of the FR 4102 initial self-assessment information collection. Each
systemically important payments and settlement system subject to the Federal Reserve's authority was required to complete
and publish its initial self assessment by December 31, 2007.
Signature of Senior Official or designee:

Date:

For OIRA Use

** This form cannot be used to extend an expiration date.
OMB 83-C

10/95