83C Change Justification Form

PAPERWORK REDUCTION ACT

CHANGE WORKSHEET

Agency/subagency

OMB Control Number

U.S Department of Education/Federal Student Aid
1845

Enter only items that change
Current record

Agency form number (s)

-

0158

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
This is a request to update the name of the servicer, address, and phone number information from MOHELA to the U.S. Department of Education through
out all six of the certification and suspension forms under OMB Control Number 1845-0158. There is no other change to the currently approved language of
these forms. There is no anticipated change in the number of respondents/responses/burden hours currently approved for this collection.

Signature of Senior Official or designee:

BETH GREBELDINGER

Digitally signed by BETH GREBELDINGER
Date: 2024.03.22 10:50:54 -04'00'

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

OMB 83-C

Date:

3/22/2024

For OIRA Use
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10/95