83c - FR Y-12/Y-12A

PAPERWORK REDUCTION ACT
CHANGE WORKSHEET
Agency/Subagency

OMB control number

Board of Governors of the Federal Reserve System

7

1

0

0

-

0

3

0

0

Enter only items that change
Current Record

New Record

39

44

103

115

Agency form number(s)

FR Y-12, FR Y-12A
Annual reporting and recordkeeping
hour burden
Number of respondents
Total annual responses
Percent of these responses
collected electronically

1,576

Total annual hours

1,755

179

Difference
Explanation of difference:

%

%

Program change

179

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**

The increase in burden hours reflects update to the FR Y-12/FR Y-12A respondent
count.
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