Form H-(e) 83-C justification

PAPERWORK REDUCTION ACT
CHANGE WORKSHEET
Agency/Subagency

OMB control number

Board of Governors of the Federal Reserve System

7

1

0

0

-

0

3

3

6

Enter only items that change
Current Record

New Record

12

15

12

15

Agency form number(s)
Form H-(e)

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

6,000

Total annual hours

7,500

1,500

Difference
Explanation of difference:

%

%

Program change

1,500

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 increase in total annual hours is due to an update in the number of respondents.
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