OMB-83C - Change Request

PAPERWORK REDUCTION ACT
CHANGE WORKSHEET
Agency/Subagency

OMB control number

Department of Homeland Security/FEMA/FIMA

1

6

6

0

0

1

0

3

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

SF-429A and SF-429B

MS Excel spreadsheets have been
developed to accompany SF-429A and
SF-429B. There is no change to the
form questions - info. collection.

Annual reporting and recordkeeping hour
burden
Number of respondents

118

118

Total annual responses

1,259

1,259

Percent of these responses
collected electronically
Total annual hours

0 %

0%

5,036

5,036
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**

There is no change to the form questions. Questions on the accompanying spreadsheets mirror the questions from SF-429A and SF-429B.

Signature of Senior Official or designee:

Date:

For OIRA Use

10052021
**This form cannot be used to extend an expiration date.
OMB FORM 83-C, 10/95

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