OMB83 C Wave 2 Pilot Q Change Worksheet

PAPERWORK REDUCTION ACT

CHANGE WORKSHEET

National Assessment of Educational Progress (NAEP) 2012 Wave II Teacher Pilot Questionnaire Change Request

Agency/Subagency U.S. Department of Education, Institute of Education Sciences		OMB Control Number 1850-0790 v.33 (EDICS # 4708)
	Enter only items that change Current Record	New Record
Agency form number(s)	NA	NA
Annual reporting and record keeping hour burden
Number of respondent	35,955	35,955
Total annual responses	35,955	35,955
Percent of these responses collected electronically	40%	40%
Total annual hours	14,603	14,603
Difference		0
Explanation of difference
Program change		0
Adjustment		0
Annual reporting and record keeping cost burden (in thousands of dollars)
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** We have realized that an omission was made in the submission of the 2012 NAEP Wave II package to OMB (1850-0790 v.32).  The BET (Background, Education, and Training) section was submitted, however the Writing-specific questions (known as the COI, Classroom Organization and Instruction) were inadvertently omitted. The respondent burden for all of the items, including the COI questions was already properly accounted for, only the 15 COI items were omitted. We are submitting a corrected “Part 3 Teacher Pilot Questionnaires (Updated 2011-09-01)” document which contains all of the approved questions from the original submittal (OMB# 1850-0790 v.32) plus the omitted COI questions and two additional questions and skip pattern in the BET section, to provide more context for the former #14 which OMB queried.
Signature of Senior Official or designee: K. Axt	Date: September 1, 2011	For OIRA Use _________________________________ _________________________________

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

OMB 83-C