83_c

PAPERWORK REDUCTION ACT
CHANGE WORKSHEET
Agency/Subagency

OMB control number

Department of Homeland Security/United States Immigration and Customs Enforcement
(DHS/USICE)

1

6

5

3

0

0

3

4

Enter only items that change
Current record
New record
Agency form number(s)

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

%

%

Total annual hours

0

Difference
Explanation of difference
Program change
Adjustment
Annual reporting and recordkeeping cost
burden (in thousands of dollars)
Total annualized Capital/Startup costs

121,390,000.00

118,590,000.00

121,390,000.00

118,590,000.00

Total annual costs (O&M)
Total annualized cost requested

2,800,000.00

Difference
Explanation of difference
Program change

2,800,000.00

Adjustment
Other changes**

There has been a change in the fee revenue.. This is a result of eliminating the I-901 receipt expedited delivery option. Nonimmigrant students and
exchange visitors will be able to print the receipt over the Internet (www.fmjfee.com)
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

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