83C Justification 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

-

0749

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
The Education Stabilization Fund- Elementary and Secondary School Emergency Relief Fund (ESSER I/ESSER II/ARP ESSER Fund) Recipient Data
Collection Form is being updated for fiscal year 2022 reporting. Tables and language have been updated to request data and information on the
appropriate reporting period. These changes do not affect the current burden.

Signature of Senior Official or designee:

ANDREW BRAKE

Digitally signed by ANDREW BRAKE
Date: 2022.10.31 11:32:47 -04'00'

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

OMB 83-C

Date:

For OIRA Use
___________________________________
___________________________________

10/95