OMB 83C Change Worksheet

PAPERWORK REDUCTION ACT
CHANGE WORKSHEET
Control Number

1660

- 0017

Enter only items that change
Cunent recod

There is no burden change to the Form.

FEMA Form: 055-0-0-1

Correction to FEMA form number.

reporting and recordkeeping hour

Number of respondents
Total annual responses
Percent of these r€sponses
collected electronically

Total annual hours
Difference
Explanation of difference

repoiling and rccordkeeping cost
(in thousands of dollars)

Total annualized Capital/Startup costs
Total annual costs (O&il)
Total annualized cost requested
Difference
Explanation of difference

The FEMA Form number was corrected on the OMB lnventory. The FEMA Form number should be FEMA From
055-0-0-1
Attached is the corrected form with the cprrect FEMA Form number.
of Senior

**

fficial

or designee:

This form cannot be used to
oMB 8$C

an expiration date.

.