Change Justification

PAPERWORK REDUCTION ACT
CHANGE WORKSHEET
Agency/Subagency

OMB Control Number

US Department of Education/ Office of Elementary and Secondary Education

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

1810-0743

New Record
N/A

Annual reporting and record keeping
hour burden
Number of respondents

52

52

Total annual responses

52

52
100

Percent of these responses
collected electronically

100

Total annual hours

260

Difference

260
0
This is request for a technical change
that will not change the burden hours
for this collection.

Explanation of difference
Program Change
Adjustment
Annual reporting and record keeping
cost burden (in thousands of dollars)

0

Total annualized capital/startup
costs
Total annual costs (O&M)
Total annualized cost requested
Difference
Explanation of difference
Program Change
Adjustment
Other change**
This change request is being made due to technical changes to this collection that will provide the grantee with
greater detail on how the GEER Fund grantee would submit their SEA Reserve budget by providing an already
OMB-approved Department form. There will be no changes to burden for this collection.

Signature of Senior Officer or
designee:

Date:

June 5, 2020

**This form cannot be used to extend an expiration date
OMB 83-C

For OIRA Use