Change Request Worksheet

PAPERWORK REDUCTION ACT
CHANGE WORKSHEET
Agency/Sub agency

OMB Control Number

US Department of Education/ Federal Student Aid
Enter only items that change
Current Record

1845-0045
New Record

Agency form number(s)
Annual reporting and record keeping
hour burden
Number of respondents
Total annual responses

63300

Percent of these responses
collected electronically

100%

Total annual hours

13375

88300
100%
19625

Difference
Explanation of difference
Program Change
0B

Adjustment

Increase the responses by 25000 *
15 minutes = 6250 additional hours

Annual reporting and record keeping
cost burden (in thousands of dollars)
Total annualized capital/startup
costs

0

0

Total annual costs (O&M)

0

0

Total annualized cost requested

0

0

Difference

Explanation of difference
Program Change
Adjustment
Other change**
The purpose of this Change Worksheet is to include additional burden hours and
respondents to the Generic Clearance for Federal Student Aid Customer Satisfaction Surveys and Focus Groups
Master Plan, 1845-0045. These increases are the results of the current balance being used up and we are
adding some more customer satisfaction surveys, which are in need to go out to the public before the revision ICR,
1845-0045, can obtains its OMB clearance (the revision ICR targeted for OMB submittal timeframe is in June 2013).
The revision ICR is currently running 60-day notice for public comment. The effected surveys currently are: Federal
Student Aid – MSURSD Enterprise Resource Planning (ERP) System Utilization Survey; Awareness and Outreach
Direct Customers Satisfaction Survey; Awareness and Outreach Train the Trainers Satisfaction Survey; and
Awareness and Outreach Peers Satisfaction Survey. It is estimated that the listed surveys and the amount we are
already over (-5845) should generate 1) and additional 25,000 responses at 15 minutes per response and 2) a total
burden increase of 6,250 hours. This represents an increase of 6,250 hours over the currently approved 13375 total
burden hours.
I need an additional 25,000 responses and additional 6250 burden hours for the remainder of this fiscal year.
Signature of Senior Officer or
designee:

Date:
5/20/13

Christine Wyatt

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

For OIRA Use