83-c

PAPERWORK REDUCTION ACT
CHANGE WORKSHEET
Agency/Subagency

OMB control number

U.S. Department of Homeland Security/Office for Civil Rights and Civil Liberties

1

6

0

1

0

0

2

4

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

DHS Form 3095

No change

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

%

%

Total annual hours

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**

DHS proposes to amend the data collection form to replace the field in Section 2 of the form for reporting the organization 's DUNS number with
Unique Entity ID (UEI). In 2022, the Federal Government transitioned from using DUNS to using UEI to identify organizations.
Signature of Senior Official or designee:

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

Date:

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