OMB83-c

1652-0071 LEOSA OMB 83C-PRA Change WorkSheet Form_.pdf

Law Enforcement Officers Safety Act (LEOSA) and Retired Badge/Credential

OMB83-C

OMB: 1652-0071

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PAPERWORK REDUCTION ACT
CHANGE WORKSHEET
Agency/Subagency

OMB control number

DHS/Transportation Security Administration/Information Technology

1

6

5

2

0

0

7

1

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**

The title of the ICR package needs to be updated from "Law Enforcement Officers Security Act (LEOSA) and Retired Badge/Credential" to "Law
Enforcement Officers Safety Act (LEOSA) and Retired Badge/Credential." All the ICR documents, list the "Safety" and not "Security."
Signature of Senior Official or designee:

Christina A. Walsh
**This form cannot be used to extend an expiration date.
OMB FORM 83-C, 10/95

Date:

For OIRA Use

9/27/2019

Reset

Adobe Professional 7.0


File Typeapplication/pdf
File TitleOMB Form 83-C, Paperwork Reduction Act Change Worksheet, October 1995
AuthorWHS/ESD/IMD
File Modified2019-09-27
File Created2007-08-09

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