83C: Change Worksheet

PAPERWORK REDUCTION ACT

CHANGE WORKSHEET

Agency/subagency

OMB Control Number

U.S Department of Education / Office of Elementary and Secondary
Education
Enter only items that change
Current record

Agency form number (s)

1810

-

0759

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
States are statutorily required by the American Rescue Plan Act (ARP Act) to demonstrate they have maintained equity with respect to high-need and highest-poverty LEAs in fiscal years 2022 and 2023 by
providing State per-pupil funding amounts for fiscal years 2019, 2021, 2022 and 2023. These requirements are outlined in Questions 19 and 20 of the approved FAQ document. Appendix A was developed to
reflect State reporting requirements for FY 2022 and failed to include the reporting elements for FY 2023 that are already outlined in the FAQ document. We are requesting a change to Appendix A to provide
clarity and ensure accuracy by adding the reporting elements for FY 2023 that have already been required of States but are not currently included in Appendix A. See the redline changes in the second
attachment.

Signature of Senior Official or designee:

ANDREW BRAKE

Digitally signed by ANDREW BRAKE
Date: 2022.07.07 13:21:51 -04'00'

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

OMB 83-C

Date:

For OIRA Use
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10/95