Signed 83-C Change Request Form

PAPERWORK REDUCTION ACT
CHANGE WORKSHEET
Agency/Subagency

OMB control number

Department of Homeland Security (DHS) / Federal Emergency Management Agency (FEMA)

1

6

6

0

0

1

5

9

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

All

All

Annual reporting and recordkeeping hour
burden
Number of respondents

287,250

1,149,000

Total annual responses

287,250

1,149,000

Percent of these responses
collected electronically
Total annual hours

0 %

732,490

0%

2,929,960
-2,197,470

Difference
Explanation of difference

2,197,470

Program change

0

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**

FEMA is revising the instruments already submitted under this generic collection and has several more to add. We are asking to increase the
alloted number of burden hours to accommodate both this round of revision and another planned round of revision.
Signature of Senior Official or designee:

Date:

For OIRA Use

3/27/2024
**This form cannot be used to extend an expiration date.
OMB FORM 83-C, 10/95

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