Change Justification Worksheet

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)

-

0103

New record

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

%

%

Total annual hours
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
This 83C is to update instructional language for clarification purposes. There is no change in the estimated number of respondents,
responses or burden hours. The change is identified in the highlighted language on pages 7-8 of the attached document.

Signature of Senior Official or designee:

Beth Grebeldinger

Digitally signed by Beth Grebeldinger
Date: 2022.03.11 16:11:52 -05'00'

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

OMB 83-C

Date:

3/11/2022

For OIRA Use
___________________________________
___________________________________

10/95