FR 4004 83-C justification

PAPERWORK REDUCTION ACT
CHANGE WORKSHEET
Agency/Subagency

OMB control number

Board of Governors of the Federal Reserve System

7

1

0

0

-

0

1

1

2

Enter only items that change
Current Record

New Record

26

14

26

14

Agency form number(s)

FR 4004
Annual reporting and recordkeeping
hour burden
Number of respondents
Total annual responses
Percent of these responses
collected electronically

%

%
26

Total annual hours

14

(12)

Difference
Explanation of difference:

Program change

(12)

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 Change**

The decrease in total annual burden hours reflects an update to the respondent count.
Signature of Senior Official or designee:

Date:

For OIRA Use

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

10/95