83c

PAPERWORK REDUCTION ACT
CHANGE WORKSHEET
Agency/Subagency

OMB control number

DHS/ FEMA

1

6

6

0

0

0

8

3

Enter only items that change
Current record
New record
Agency form number(s)

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

%

%

Total annual hours

0

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)

0.00

Total annualized cost requested

0.00
0.00

Difference
Explanation of difference
Program change
Adjustment
Other changes**

FEMA Form 116-0-1, is the Main Loan Application for collection 1660-0083. In the process of addressing specific loan application terms and
conditions for the U.S. Virgin Islands the mail Loan application was mistakenly left out of the ICR package. There is no change to the Burden hour
Signature of Senior Official or designee:

Date:

For OIRA Use

7/24/2019
**This form cannot be used to extend an expiration date.
OMB FORM 83-C, 10/95

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