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pdfPAPERWORK REDUCTION ACT
CHANGE WORKSHEET
Agency/Subagency
OMB control number
DHS, National Protection and Programs Directorate, Office of Infrastructure Protection
1
6
7
0
0
0
1
3
Enter only items that change
Current record
New record
Agency form number(s)
DHS Form 9014
DHS Form 9014
Annual reporting and recordkeeping hour
burden
Number of respondents
250
450
Total annual responses
250
450
100 %
100 %
Percent of these responses
collected electronically
Total annual hours
42
75
-33
Difference
Explanation of difference
Program change
Adjustment
Annual reporting and recordkeeping cost
burden (in thousands of dollars)
Total annualized Capital/Startup costs
Total annual costs (O&M)
0.00
Total annualized cost requested
0.00
0.00
Difference
Explanation of difference
Program change
Adjustment
Other changes**
SEE ATTACHED
Signature of Senior Official or designee:
**This form cannot be used to extend an expiration date.
OMB FORM 83-C, 10/95
Date:
For OIRA Use
Reset
Adobe Professional 7.0
| File Type | application/pdf |
| File Title | OMB Form 83-C, Paperwork Reduction Act Change Worksheet, October 1995 |
| Author | WHS/ESD/IMD |
| File Modified | 2011-07-08 |
| File Created | 2007-08-09 |