FR 4100 (83c)

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

9

Enter only items that change
Current Record

New Record

Number of respondents

188

170

Total annual responses

188

170

Agency form number(s)

FR 4100
Annual reporting and recordkeeping
hour burden

Percent of these responses
collected electronically

5,496

Total annual hours

5,892

396

Difference
Explanation of difference:

%

%

Program change

396

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 net increase in burden hours reflects a decrease in the number of respondents in the recordkeeping requirement with a
lower time per response and an increase in the number of respondents in the disclosure requirement with a higher time per
response.
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