83C Change Justification Form

PAPERWORK REDUCTION ACT

CHANGE WORKSHEET

Agency/subagency

OMB Control Number

U.S Department of Education
1845

Enter only items that change
Current record

Agency form number (s)

-

0163

New record

Borrower Defense to Loan
Repayment Universal Form
Annual reporting and recordkeeping hour
burden
Number of respondents

96,000

Total annual responses

96,000

Percent of these responses
collected electronically
Total annual hours

%

%

48,000

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)
Total annualized cost requested
Difference
Explanation of difference
Program change
Adjustment
Other changes
FSA is only updating the contact information for submission of this application. The change is at the top of page 25 of the Borrower
Defense General Application Form. There is no other change to the form or to the estimated respondents/responses/burden hours.

Signature of Senior Official or designee:

Beth Grebeldinger

Digitally signed by Beth Grebeldinger
Date: 2021.09.01 10:01:06 -04'00'

** This form cannot be used to extend an expiration date.

OMB 83-C

Date:

9/1/2021

For OIRA Use
___________________________________
___________________________________

10/95