83c

PAPERWORK REDUCTION ACT

CHANGE WORKSHEET

Agency/subagency

OMB Control Number

Department of Homeland Security/FEMA

0102
1660
___ ___
___ ___ - ___
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Enter only items that change
Current record

Agency form number (s)

FEMA Form: 007-0-1,(9/14)

8601 Georgia Avenue, Suite 505
Silver Spring, MD 20910

New record

P.O. Box 7759
Silver Spring, MD 20907

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

%

%

Total annual hours
Difference
Explanation of difference
Program change
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 changes**

Signature of Senior Official or designee:
Digitally signed by DAWSON W RIGGLEMAN JR
DN: c=US, o=U.S. Government, ou=Department
of Homeland Security, ou=FEMA, ou=People,
cn=DAWSON
W RIGGLEMAN
JR,
extend
an expiration
date.

0.9.2342.19200300.100.1.1=0690874669.FEMA.
1
Date: 2016.10.17 11:42:18 -04'00'

DAWSON W
** This form cannot be used to
OMB
83-C
RIGGLEMAN
JR

Date:

10-17-16

For OIRA Use
___________________________________
___________________________________

10/95