Download:
pdf |
pdfUNITED STATES DEPARTMENT OF EDUCATION
OFFICE OF MANAGEMENT
CHIEF PRIVACY OFFICE
INFORMATION COLLECTION CLEARANCE DIVISION
PAPERWORK REDUCTION ACT CHANGE WORKSHEET
Agency/Subagency:
OMB Number:
Office of Special Education Rehabilitative Services (OSERS)
1820-0028
Enter only items that change.
Annual reporting and recordkeeping hour burden:
Current Record
New Record
Agency form number(s)
Annual reporting and recordkeeping hour burden:
Number of respondents
800
800
Total annual responses
800
800
100%
100%
20,000
21,200
Percent of these responses collected electronically
Total annual hours
Difference:
1,200
Explanation of Difference:
0
Program Change
Adjustment
1,200
Annual reporting and recordkeeping cost burden
(in thousands of dollars):
Current Record
New Record
Total annualized capital/startup costs
$0
$0
Total annual costs (O&M)
$0
$0
Total annualized costs requested
$0
$0
Difference
$0
Explanation of Difference:
Program Change
$0
Adjustment
$0
Other Change:** (2,000 characters max). An attachment may be included with this form to provide additional information.
The time required to complete this information collections is estimated to average 26.5 hours per response, including the time to
review instructions, search data resources, gather the data needed, and complete the collection. The purpose of this change
worksheet is to include the OMB approved"Evidence Form" (1894-0001) instrument in the Part D Discretionary Grant Application
Package-IDEA under the approved OMB control number (1820-0028). The "Evidence Form" is attached.
Signature of Senior Officer or Designee:
Larry Wexler
For OIRA Use:
**This form cannot be used to extend an expiration date.
OMB 83-C 8/2017
Digitally signed by Larry Wexler
DN: c=US, o=U.S. Government, ou=U.S. Department of Education, cn=Larry Wexler,
0.9.2342.19200300.100.1.1=9268314360
Date: 2017.11.30 07:33:47 -05'00'
Date: 11/30/2017
| File Type | application/pdf |
| File Modified | 2017-11-30 |
| File Created | 2016-04-07 |